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.___ III IIIIIIIIIIIIIIII <br />7,78 ,:-~ ~.: <br />lMITED IMPA1CT (110) and QQ 999 <br />II:L TEN-DAYR,(i l l) PEP,MIT I p~ 1 a ' <br />~^J~PLICATION FORM .l~~i(p.~ ~ <br />State of Colorado ~~~`,~ F'~ Application for Mining and <br />Department of Natural P,esources Reclamation Permit, pursuant <br />MINED LAND RECLAMATION BOARD to CRS 1973, 31+-32-101, et seq <br />1313 Sherman Street, Room 723 <br />Denver, CO 80203 (303) 839-3567 ;j 1979 <br />The following explanations cover ~n~ed .~{rrldc~Ga¢R@~~L4@Jgons (110s) and Special (Ten- <br />Day Processing)(llls) applicati IVn the interests of efficient processing, please <br />check the appropriate box to ind ich type of application you are applying for here. <br />X LIMITED IMPACT OPERATIONS must dis LESS THAN ten acres (including <br />all roads, stockpile areas and any other surface facilities) over the <br />life of the mine, and must extract LESS THAN 70,000 tons of mineral, <br />overburden or combination thereof per calendar year. If the affected <br />area is some fraction greater than nine acres, be sure NOT to round this <br />figure out to ten acres in the narratives or elsewhere. <br />SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN ten acres <br />(including all roads, stockpile areas and any other surface facilities), <br />and can ONLY be obtained where a federal, state, county, city, town or <br />special district contract calls for work to be commenced within a <br />SPECIFICALLY SHORT TIME. I l~f? N0' ly O_I ~ I _' <br />(Type or Print Clearly) <br />1. Name of operation NS <br /> (Pit, mine or site name) <br />2. Name of applicant/operator <br /> (Name to be used on permit) <br />3. Address and phone number of <br />local offices , <br /> <br />4. Address and phone number of <br /> general offices <br />Tele hone: (303) 254-7271 'i <br />5. Name and phone number of person <br /> staff members should contact <br />Tele hone: 303 <br />2~~~ <br />6. Owner(s) of record of affected <br />land (surface area) ( I f more <br />FRED L. KORINEK <br />and LUCY L. KORINEK, <br /> than 2, list below) <br />Joint Tenants <br />7. Owner(s) of substance to be mined FRED L. KORINEK and LUCY L. KORINEK, <br /> (If more than 2, list below) <br />Joint Tenants <br />8. Source of legal right to enter <br />(Indicate what type of proof is <br />Deed <br /> included in EXHIBIT G - lease, <br />deed, notarized letter, etc.) <br />9. Type of mine & substance to be <br />mined (Specify underground, strip, <br />~3'3. 'y - -- _ _ _ _ <br />- <br /> open pit, etc. ~ substance(s) to <br />be mined) <br />10. General location s elevation <br />(Miles b direction from nearest _ <br />' <br /> town E approximate site eleva- <br />tion) <br />4,200' - 4,250' <br />elevation <br />il. County <br />12. Acreage of affected lands <br />(Total surface acreage to be <br />included in ermit <br />Eight and one-half ~m <br />13. Application fee (See applicable <br />RULE to determine amount) <br />One Hundred Ten <br />Dollar~~Y <br />i nab <br />~6~ <br /> <br /> <br />