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Doc Die iz/~~/o/ <br />DEPARTMENT OF NATURAL RESOURCES <br />Davin M. Gatcnea. Exaoutlve Director <br />MINED LAND RECLAMATION DI\ <br />DAVID C. SHELTO N, Director <br />Ficnara D. Lamm <br />Govamor <br />Application Form for a Permit <br />to <br />Conduct Coal Mining in Colorado <br />Application to conduct surface or underground coal mining activities or other <br />surface coal mining and reclamation operations in Colorado pursuant to C.R.S. <br />1973, 34-33-101, et seg. <br />For an application to be deemed complete by the Division pursuant to C.R.S. <br />1973, 34-33-103(5) and Rule 1.04(30), an applicant must: (1) supply all <br />information as specified on this application form; (2) submit five <br />reproducible copies of the permit application with original signatures; and <br />(3) pay the appropriate fee required by Rule 2.01.6. <br />Please note that this form is only a listing of general category requirements <br />and does not constitute a checklist of detailed permit application <br />requirements. A finding of completeness should not be interpreted to imply <br />adequacy of an application. Additional information not listed on this form <br />may be required for adequacy depending upon the individual circumstances of an <br />application. <br />• This form consists of two major parts: (1) a section entitled (General <br />Operation Information and (2) a section entitled Application Requirements. <br />Specific instructions for filling in the necessary information for each <br />section appears immediately below the title of each section. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly the appropriate information as listed below. <br />Supplemental sheets may be used as necessary, such sheets must be attached to <br />the form and referenced or keyed to the numbers on the farm. <br />1. Flame of Operation <br />(Pit, mine or site name) <br />2. Name of Applicant <br />(Name to be used on permit - <br />the Permittee) <br />2a. Address and phone number of <br />local offices <br />2h. Address and phone number of <br />general offices. <br />Foidel Creek Mine <br />Twentymile Coal Company <br />80467 <br />Box 897 <br />Oak Creek, Colorado <br />(303) R79_A~6~ <br />5250 South 300 West <br />Salt Lake City, Utah <br />(801) 263-3850 <br />84107 <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (30a) 866-3567 <br />