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LIHITED IMPACT A.YD SPECIAL (I'E.`7-DAY) • /~ '' ~ <br />,+~ l J <br />FERRIS APPLIGTION FORM )`.kl.~ <br />STATE OP COLORADO R ~~~,~ Applieatian toe Mlaing ' <br />lflaed Land Reclamation board and 14elawtion Parmit,~ <br />Department of Natural Resources ~~ ~ Pursuant to C.R.S. 1979, <br />1317 Sherwn scra.c, Room 723 ~~~ ~ ,~ •~ 1980 3<-32-101, et ..q. ~ . <br />Denver, Colorado 80203 w <br />LIIfITED IMPAC7 OPEMTIONS emac diaeurj~ L ¢$ '~i~~Fen acres (including all <br />roads, •coekp£le ar~~~a~ ~,yp~~}®h~~i~1~N~ f1h1'l !else) over the ~lita of <br />Che mina, and suet j,:4na~ej,$S~Ti~j7 ~~(C~$00}£t8$ mineral, everburdem <br />os coati iTU Lion they -Pp ~~++jjl aC~ir`"' eas. If cha affeeiad area is sow <br />freer ion gres car than nine aerea, ba sure N07 to round SC up to tan aerea <br />in the nartac Twee or elsewhere. <br />SPECIAL (TEN-MY PROCESSING) opera [ions soar disturb LESS MAN tan <br />acres (including all roads, stockpile areas and anq other auefaca <br />facilities), snP can ONLY be obtained vhe ra a federal, seats, eouatq, <br />e1tq, cow, or special die crier contract calla for wrk to ba <br />eomanced within a SPECIFICALLY SHORT TIlfE. {1,\I \ 1 <br />irFE OR FRINT CLFaRT.2 ~ \IZ 1UD . ~V ~`~ <br />1. Nma et operations __ _~p, I Pvel <br /> (Pit, aiw, or alto Hama) <br />2. Nana of applicant/ep.r.cnr Fed'~raZ 17e <br /> (New to ba used on paretic) <br />3. Address and phone number o£ ` <br /> local of flees <br />4. Address and phone number ~~ '~~~$()~, Salt Lake Cit , UT <br /> of general offfeu 8 <br />5. New and phone number of person ~F`-lar ~# }wne^}Yd 1r <br /> •uff aembars should coneaee f 3,~ 5 r1r 745-Fi741 <br />6. Owar(a) of racora o[ affected j~3~1 F. Dismant <br /> l,na (.nrr^re .re,) Ourav . CO 81427 <br /> (IL sore than 2, list below) <br />I. Ower(a) e[ eubatanca co bs mines Carl F. Dismant <br /> (If more than 2. list below) <br />g. Source of legal right co enter j~jnta ri2Ptj IP*tPr <br /> . (Indicac• what type o£ proof !a <br />Secluded 1n Cahib it C - lease, dead, _ <br /> notarized letter, ere.) <br />9. Typo of alma i subetanee to ba aimed jjarei ernrk• _~>z'tST1I)Q <br /> (Spaelfq underground, strip, open pit. <br />ere. and subetaaea(s) to bs mined) <br />0 General location i <br />levat ion (Miles '~~ ~--n.."-~ ~`~~ <br />. <br />. a <br />i direct loo lzoa nearnet town i <br /> approaimau a1C• elsvatlon) <br />1. Coua[q _ <br />2. Acreage of •ffaeced lands <br />(T <br />L <br />b <br />l <br /> ota <br />u acreage co <br />wr <br />• <br />included !n pereSt) <br />3. Appliutlon fee (Sea appllcabl• Rule ~ ~` <br /> to determine aswunc) <br />84110 <br /> <br />