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APPLICATION FOR AIR POLLUTION EHISSION PERMIT OR PERMIT MODIFICATION <br />This application must be filled out completely except for pl4 6 N15; otherwise, application <br />w.i•ll' be considered incomplete - SEE INSTRUCTIONS ON REVERSE SIDE. Hail completed application, <br />AFE11s, and filing fee to: Stationary Sources Program, Air Pollution Control Division, <br />ipl.arado Department of Health, 4210 East Ilth Avenue, Denver, Colorado 80220. (303/ 331-8576) <br />_ RERHIT TO BE ISSUED T0: <br />Lillylands Inc. <br />2_ HAILING ADDRESS: <br />State: <br />P.O. Box 204, Redvale, CO ZIP LOGE: 81431 <br />~_ AGENT FOR SERVICE (See No. 3 on reverse?: <br />navid L_ Andrews <br />4a:. GENERAL NATURE OF BUSINESS: b. SIG Code: <br /> Open Pit Coal Mine - New Mine <br />~_ AIR POLLUTION SOURCE DESCRIPTION: CHECK IF EQUIP. I$ PORTABLE Sb. Days per year <br /> source will operate <br /> Coal Mining 0 eration 250 <br />_ SOURCE LOCATION ADDRESS: Check if map included: x b. UTM Coordinates <br /> (in km): <br /> O OUNTY Montrose <br />' H <br />V <br /> m <br />es southeas o ita _ _ _ _ _ _ <br />_ _ <br />1. ES7IHATED COSTS: Air Pollution Control Procedures or Equipment: <br />ya- Source, Process Equipment or Project: 7b. Capital Cos t: $75,000 Annualized:515K <br /> Cap. <br />Cost•$4.000.000 Annualized:$ ann.nOn <br />7c. Operating Cost $140,000 /y r. <br />_ STATUS <br />iiew Air Pollution Source <br />Existing Source Change (Control equipment added, process change, etc.): <br />^ Other: <br />s for Construction to: <br />8b. Begin: May 1gg1 8e. End: ,Tune 1991 <br />Source Startup Date: <br />8d. May 1991 <br />g. Enclose check [o cover APEN FILING FEES. One APEN should be filed for each emission point: <br /> 1 APENs @ $40.00 per APEN $ 90.00 <br />L0. SIGNATURE OF LEGALLY AUTHORIZED PERSON N07 vendor Ila. DATE SIGNED: Ilb. TELEPHONE NO.: <br /> or 'equipm ~t,r~anufact r): <br />l/ <br />(303) "~~'7-asna <br /> / <br />~ <br />~? <br />/ i 19 9/ <br /> ~ ,~ <br />.~ <br />1Z. Type or print name and official title of person sign' g i em 10. A~enc~y Use Only <br /> IO DATE RECEIVED <br /> David L. Andre:os, President. Lillylands Inc. <br />Ij. Check appropriate box if you want: <br /> a. ^ Copy of preliminary analysis conducted by Division <br /> b. ~ To review a draft of the permit prior to issuance? <br /> NOTE: Checking either item could result in increased fees 15. PERMIT NUnBER <br />. or processing time. See Reverse. - <br />APCO:ssP: (Rev. 11/87 - 1214f) <br />Dock 2000 <br />