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4- <br />- Application Form for a Permit <br />r to <br />Conduct Coal Mining in Colorado <br />State of Colorado Application to conduct surface <br />Ds~:-rtment of Natural Resources R~Cf~(~t~ or underground coal mining <br />s <br />.i MIMED LAND RECLAP:ATION DIVISION activities or other surface coal <br />1313 Sherman Street, Room 423 ~ mining and reclamation operations <br />Denver, Colorado 80203 (303)839-3567 F ~ B 1 7 1~..~ in Colorado pursuant to CRS 1973, <br />39-33-101, et. se . <br />'MINED LAND AICLAMATIEIN•E9Ali <br />~~ pyf, o~ ~ntul~u Ntiou6ES <br />For an application to be deemed complete by the Division pursuant to CRS 1973, <br />34-33-103 (5) and Rule 1.04 (30), an applicant must: (1) supply all information. as <br />specified on this application form; (2) submit five reproducible copies of the permit <br />application with original signatures; and (3) pay the appropriate fee required by <br />Rule 2.01.6. <br />i~ <br /> <br />Please note that this form is only a listing of oeneral category requirements and <br />does not constitute a checklist of detailed permit application requirements. A <br />finding of completeness should not be interpreted to imply adequacy of an appli- <br />cation. Addtional information not listed on this form may be required for adeouacy <br />depending upon the individual circumstances of an application. <br />This form consists of two major parts: (1) a section entitled General Operation <br />Information and (2) a section entitled Application Requirements. Specific instruc- <br />tions for filling in the necessary information for each section appears immediately <br />below the title of each section. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly the appropriate information as listed below. Supplemental <br />sheets may be used as necessary, such sheets must be attached to the form and re- <br />ferenced _or keyed to the numbers on the form. <br /> + <br /> (Pit, mine or <br />site name) Coal Gulch Mine <br />2. Name of Applicant Arness - McGriffin Coal Company, <br /> (Name to be used on permit - a Colorado corporation <br /> the permittee) <br /> 1].39 Main Avenue <br />2a. Address and phone number of Durango, Colorado 8].30] <br /> local offices Phone: (303)-259-1507 <br /> c /o John J . We J sh Phone : ( 415) - <br />2b. Address and phone number of One Maritime Plaza 956-7.900 <br /> oeneral offices. San Francisco, Ca]ifornia 9411]. <br /> Sam Arness phone: (9].6)-629 <br />;. ':ame and phone number of person p G, gox ] 126 <br /> staff members should contact WilJ.ow CreeY., California 95573 <br />s. Parent Corporation, if any <br /> (Include name and address) [lot Appl icab] e <br />~.__ --~ <br />•2749 <br />i <br />•.. ~{~ <br />