PERMFILE63313

• Permit No: M1995038
• IBM Index Class Name: Permit File
• Doc Date: 5/16/1995
• Doc Name: LIMITED IMPACT OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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CHECK ONE:
LIMITED i,,,.,~, vrcnnilun (110(2))
RECLAMATION PERMIT
APPLICATION FORM
~~~*~ ~
MAY 16 19y5
~~ ~,:,, ~~ minerals & Geology
New Application (Rule 3.2) Amendment Application (Rule 1.8)
Conversion App 1'i cation (Rule 1.10)
The application for a Limited Impact Operation Reclamation Permit contains three major
parts: (1) the application form; (2> Exhibits A-J; and, (3) the application fee. When
you submit your application, be sure to include one (1) sieved original and one (1) copy
of the application form, two (2) copies of Exhibits A-J, and a check for the application
fee described under (3> below. To expedite processing, please provide the information
in the format and order described in this form.
xazxaaaaxaaaaxxaaaasxaaaasxxsaaaaaaaazzzxzaaazxxxaaasaaazxxsxaaaaxxsxaaaaxsxxa=aaaaaaasxx
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, ail information described below.
asxxaaaasaaxaaaxsaaazsaaaaaxaaaaaaxaaxasazxxaaaaasxxsazaacaaazxxzzaaaaaxxzsaaaaaaaaaaaszz
1. Applicant/operator name: ~i~f~/nt~S Cvi~Sff7
1.1 Type of organization (corporation, partnership, etc.): ~~,S~D
2. Operation name (pit, mine or site name): ~7~na^ ~ f"" ~
2.1 I.R.S. Tax ID No. or Social Security No.: ~y-/~S~ISCOI /,o~.~~~.~

~Kt~, J
3. Permitted acreage U L d ~~ wJ~~z ? 1~ permitted acres "
3.1 Application Fee (New Application Only)
4. Substance(s) to be mined (e.g., gravel/gold/borrow)
7
5875.00 application fee
C-~~a~ ~r
5. Name of owner of surface of affected land: eTr~ ~a
6. Name of owner of subsurface rights of affected land: (`l r,p ~l O~Y~
7. Type of mining operation: ?iSurface _ Underground _ In-situ
8. Location information. The center of the area where the majority of mining will
occur lies in:
COUNTY: ,5',4Nh~~~~c!
PRINCIPAL MERIDIAN (check one): _ 6th (Colorado)10th (New Mexico) Ute
TOWNSHIP (write number and Check direction): T >( North South
RANGE (write number and check direction): R ~• _ East ( West
SECTION (write number): S i
QUARTER SECTION (check one): NE ,~ NW SE SW
QUARTER/QUARTER SECTION (check one): _ NE _ NW _ SE ~ SW
GENERAL DESCRIPTION:
(miles and direction ~~ ~i/P~;~t,~~a_!/Vn~f~~~rr~'ll~~nlmrl, fir,
from nearest town and
approximate elevation) ~ d „~,,r/pr~5/~y~er ~ of
~ect~o/z l9 o~,vr>~-r-gyp -~15 G1~<~-I ~
pRrG~NAL