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• . STATE OF COLORADO_ <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natura! Resources Q^~ <br />1313 Sherman St, Room 215 - I c (, C O L D RA D O <br />Denver, Colorado 80203 ~, n Q~ ~/ 211' ,I',t ,^" ~~ D 1 v 1 5 1 O N O F <br />Phone: (303) 8663567 JV `' ~ yr, ,9ryy ~ M I N E RA L S <br />FAX: (3031 832-8106 ~ /,~ S I A~~/ ~ 0/vis/on o fMr ? 20p6 ~ ~. G E O L O G Y <br />1~i 0.ECLANATION•MINING <br />nC~ SAEET Y•SC IENCE <br />a/S a, <br />REGULAR (112d) DBSIGNATED MINING OPBN <br />1/ BiB Owens <br />(/ RBCLAbIATION PBRMIT covemor <br />APPLICATION FORM Russell George <br />Executive Director <br />Ronald W. Cattarly <br />Divrsion Director <br />Natural Resource Trustee <br />CHECK ONE: J New Application (Rule 1.4.5} ~ Amendment Application (Rule 1.10) <br />_ Conversion Application (Rule 1.11) <br />Permit No. M-~~-"3~~ (provide for amendments and conversions of <br />existing permits) <br />The application for a Regular {112d) Designated Mining Operation Reclamation Permit <br />contains three major parts: (1) the application form; (2) Exhibits A-T, Geotechnical <br />Stability Exhibit, the Emergency Response Plan, and Addendum 1, as required by the <br />Office, and outlined in Rules 6.1, 6.2, 6.3, 6.4.19, 6.5, 8.0, and 1.6.2(1)(b); and, (3) <br />the application fee. Nhen you submit your application, be sure to include one (1) signed <br />and notarized Gray orisinal and four (4) copies of the application form, five (5) copies <br />of Exhibits A-T, Rule 6.5 Geotechnical Stability Exhibit, the Emergency Response Plan, <br />Addendum 1, and a check for the appropriate application fee (described under Section (4) <br />on Page 2). Exhibits should not be bound or in a 3-ring binders; maps should be folded to <br />8 34'1 x iln or 8 35n X 14n size. To expedite processing, please provide the information in <br />the format and order described in this form. <br /> <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br /> <br />1. Applicant/operator or company name (name to be used oa permit): <br />7 l~Y~ ~ ~L/wtr4-K /y1C~C,YSDcr~/~CAC~t PoHOpA1Uy tl- <br />1.1 Type of organization (corporation, partnership, etc.): ~r,p~O,~y7D.L1 <br />1.2 Z.R.S. Tax ID No. or Social Security Number: /3-(0l/~6~t/n <br />2. Operation same (pit, mine or site name): [YZ~vDfe50~J /H/^'« <br />3. Permitted acreage: (new or existing site) 3S~,~i acres <br />3.1 Change in acreage (+) ~'~0 acres <br />3.2 Total acreage in Permit area 3~0~,8 acres <br />