PERMFILE63232

• Permit No: M2001070
• IBM Index Class Name: Permit File
• Doc Date: 7/8/2001
• Doc Name: HARD ROCK METAL MINES LIMITED IMPACT OPERATION 110 2 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
Department of Nawral Resources
1313 Sherman Sl.. Room 215
Uenver, Colorado 80203 VO
Phone: [phone]
FAX:[phone] t
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HARD ROCK/MHTAL MINHS ~ ``~ ~ o ~~
LIMITBD IMPACT OPBRATION 110(2)) ~ ~'~••~
RBCLAMATION PERMIT APPLICATION FORM ,_n0~'"
DEPARTMENT OF
Roy Romer
Governor
lames 5. Lochhead
Executive Dvetlor
M¢hael8 Long
Division Director
CHECK ONE: X New Application (Rule 1.4) Conversion Application (Rule 1.11)
Permit # M-~n~ - b70 - (provide for Conversions of existing permits)
The application fora Limited Impact (110(2)) Mining Operation Reclamation Permit contains three
major parts: (1) the application form; (2) Exhibits A-J, Addendum 1, any sections of Exhibit S
and Geotechnical Stability Exhibit, as required by the Office, and outlined in Rules 6.1, 6.2,
6.3, 6.4.19 and 6.5; and (3) the application fee. When you submit your application, be sure to
include one (1) signed and notarized Grev Original and one (1) copy of the application form, two
(2) copies o£ Exhibits A-J, appropriate sections of 6.4.19 (Exhibit S), and 6.5 (Geotechnical
Stability Exhibit), as required, and a check for the application fee described under (4) below.
Exhibits should NOT be bound or in 3-ring binders; maps should be folded to 8 1/2" X 11" or
8 1/2" X 14" size. To expedite processing, please provide the information in the format and order
described in this form.
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GENERAL OPERATION INFORMATION
Type or print clearly, in the apace provided, all information described below.
------------------------ ----------------------___=----_________________________
1. Applicant/operator or company name (name to be used on permit):
Wallace F. Burtis
1.1 Type of organization (corporation, partnership, etc.): Individual
2
3
4
1.2 I.R.S. Tax ID No. or Social Security Number:
Operation name (pit, mine or site name): Florence Pit
Permitted acreaoe:
Fees:
4.1 New Application
0.84 permitted acres
5875.00 application fee
4.2 Conversion Fee (from 110d to 110{2), Rule 1.11.2(2)) $E75.00 application fee
5. • Primary commodities to be mined: Turquoise
6. Name of owner of the subsurface rights of affected land:
7. Name of owner of the surface of affected land:
Wallace F. Burtis
Wallace F. Burtis
a. Names of the holders of any recorded easements on the affected land:

8. Type of mining operation: X Surface Underground In-situ