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LIMITED IMPACT AND SPECIAL (TE:t-DAY)
<br /> PERMIT APPLICATION FORM
<br /> STATE OF COLORADO Application for Mining
<br /> rMined Land Reclamation Board E C L_I VE D and Reclamation Permit,
<br /> Department of Natural Rasources Pursuant to C.R.S. 1973,
<br /> 1313 Sherman Street, Room 723 34-32-101, at seq.
<br /> Denver, Colorado 80203 0 C T 3 1977
<br /> LIMITED IMPACT OPE�W}�iIO�JyS^,,°q��4°p }1�a�-t'�urb LESS TllAtt ten acres (including all
<br /> roads, stockpile ar6Yslland�an�dC"SCOoT0D QP�cilitles) over the life of
<br /> the mine, and must W*V"LWr,, PR JJJ,,�pt�s of mineral, overburden
<br /> or combination thereof per calen r yea . '1`F3he affected area is coma
<br /> fraction greater than nine acres, be sure NOT to round it up to tan acres
<br /> in the narratives or elsewhere. ,�1 q ss�
<br /> SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN tam r j.pty
<br /> acres (including all roads, stockpile areas and any other surface Cl.c•-�� `w�
<br /> facilities), and can ONLY be obtained where a federal, state, county, ss,pa
<br /> city, town, or special district contract calla for work to be
<br /> commenced within a SPECIFICALLY SHORT TIME. '
<br /> TYPE OR PRINT CLEARLY
<br /> 1. Name of operations =KE Ale. 1. M,N
<br /> (Pit, mine, or site mama)
<br /> 2. Name of applicant/operator W. $ , DA WS D 14
<br /> (Name to be used on permit)
<br /> 3. Address and phone number of P•O•Bo X 3737
<br /> local office I
<br /> N D U Un/C iO^l /So
<br /> 4. Address and phone number _ 30 - 25/ 3
<br /> of general offices
<br /> 5. Name and phone number of person lc/, .S,DAWSo.J
<br /> staff members should contact 3413-2- Z— /G5-3
<br /> 6. Owner(s) of record of affected a✓,E MtN
<br /> land (surface area)
<br /> (If more than 2, list below)
<br /> 7. Owner(s) of substance to be mined _
<br /> (If more than 2, list below)
<br /> - R. Source of legal right to enter I .EASE
<br /> _ (Indicate what type of proof is
<br /> included in Exhibit C - lease, deed,
<br /> notarized letter, etc.)
<br /> 9. Type of mine 6 substance to be mined
<br /> (Specify underground, strip, open pit,
<br /> etc. and substaace(s) to �e mined)
<br /> 10. General location 6 elevation (Miles
<br /> 6 direction from nearest town
<br /> approximate site elevation)
<br /> 11. County Sit.
<br /> 12. Acreage of affected lands
<br /> (Total surface, acreage to be
<br /> included 1n permit) 't
<br /> 13. Application fee (See applicable Rule SS
<br /> to determine amount)
<br /> SfMT
<br /> !y G 92!/J rt 14 046
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<br /> C4 c A /ON
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<br /> lJO 2 C3 � R D A b+..x. R.(-� nrcrrt¢��_ �C2S(� 7� •�, ('d. R�.SO/
<br /> C_
<br /> /Z 1974,
<br /> Ap
<br /> l• ,•,ts. ,C, 71
<br /> S S,e 7 N / o A O
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