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i\ .. - <br />._.. <br />T«TED Pc~ACT AND SPECIAL (TEN) <br />PERMIT APPLICATIO:i FORM <br />9 c "- <br />III IIIIIIIIIIIII III <br />sss <br />STATE OF COLORADO R ECE~ <br />Mined Land Reclamation Roard <br />Department of Natural Resources <br />1313 Sherman Street, Room 723 JAN 1 1 15..u <br />Deaver, Colorado 80203 <br />Application for Mining <br />and Reclamation Permit, <br />Pursuant to C.R.S. 1973, <br />34-32-101, et seq. <br />MINED LAND RECD'-: ~'~~ <br />LIMITED LMPACT OPERATIONSqq.~~ ~i~y~1,;LESSi.~1T~AN ten acres (including all <br />gads, stockpile areas and any other surface facilities) over the life of <br />the mine, and must extract LESS TAA:l 70,000 tons of mineral, overburden <br />or combination thereof per calendar year. If the affected area is some <br />fraction greater than nine acres, be sure NOT to round it up to tea acres <br />in the narratives or•elsewhere. <br />SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN tea <br />acres (including all roads, stockpile areas and app other su=face <br />facilities), aacc can ONLY be obtained where a federal, state, county, <br />city, town, or special district contract calls for work to be <br />commenced within a SPECIFICALLY SHORT TIME. 1~ <br />TYPE OR PRP1T CLEARLY ~ ~D`~ <br />1. Name of operatj,gns .~~ ~~~ SPI~~/~ /iT `~ <br /> (Pit, mine, or site name) <br />Z. Name of applicant/operator ~d Q6- <br /> (Name to be used on permit) I <br />3. Address and phone number of I ~~. L30k /h~~ / /i/2~/~/P,~ (0%0, ~~1~~~ <br /> local offices 3~ _ ~~• <br />4. Address and phone number S~yt~.C <br />. of general offices <br />5. Name and phone number of person ~ A /T Cr- <br /> staff members should contact <br />6. Owner(s) of record of affected i ~ ,e./1 <br /> Iand (surface area) <br /> (If more than 2, list below) <br />7. Owner(s) of substance to be mined 5,~~ ~ <br /> (If more than 2, list below) <br />8. Source of legal right to enter ~ ~,qs~, <br /> (Indicate what type of proof is <br />included is Exhibit G - lease, deed, <br /> notarized letter, etc.) <br />9. Type of mine 6 substance to be mined - 6ti~ <br /> (Specify under3round, strip, oven pit, <br /> etc. and substance(s) to be mined) <br />0. General location 5 elevation C"111es 5~~ ~~ ~ /~o T~/S ~7S/L/ <br /> b direction from nearest town ~ <br /> approximate site elevation) <br />I. County <br />Z. Acreage of affected lands <br />~ ~J <br />~r"p~ <br /> (Total surface acreage to be <br />included is permit) i - <br />3. Application fee (See applicable Rule <br /> to determine amount) <br />