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MAR B9 '93 09:26RM DIViMTVN~~R~S~G~0~0L~ANUE IN STATUS <br />,-~ 'MINE NUMBER ~ I5 THIS A NEW OPERATION? <br />Will Permits be required? <br />Mine or Operation Name ~i.~ Rm~ Co4i ~~wi~ <br />OWNER <br />Name ~~~n~K Co.rc. Ce--.~n^• y <br />Address /3.5~ *_+ ~'" S ~ra 3~ <br />su1~ rA /1, CO QO~oz, <br />Telephone (303) sue- 7yaS- <br />P.2c3 <br />(yes/no) <br />bieeel <br />Explosive <br />OPF~I2ATOR <br />~ .., ¢. <br />(check one) Corporation (~ Partnership ( ) Individual ( ) <br />(If Incorporated or partnership complete aeotion XX) <br />(List all Contreotore complete aeotion py) <br />Location of operation 3 ~"-~ ~TO~ Ti.(~~v,pq.O, Ccx0- <br />1/4 aeotion Section 2 Township 33 S Range~~~/ ' <br />Countplas Av~~kS County No. <br />Person in charF.e `~K ~~, Telephone (3031 99r si3~ <br />Address y9Oi S• 7,u.NG.`~Rn+I3,4Fi Title O s b/~( <br />G~T72aro.v CO boi.to <br />ZIP ~/moo <br />STATCTS (cheek one) <br />Producing ( ) Exploring ( ) Drvaloping ( 1 <br />Abandoned ( ) Idle (~ Rehabilitation ( ] <br />RIND OF OPERATION <br />`fine (DiJ Surfaoe Mine (t~ <br />Prep Plant ( ) Tunnel ( ) <br />Underg ou <br />average number of employcee ( ~') <br />Operation will be aonduoted (~) <br />' (~) <br />(ahQCk one) <br />Plneer ( ) Mill <br />Tourist ( ) Mine & Mili/Plant <br />,d Surface mine Surface Facilit}- <br />I!) l~) <br />days a week ( _) hours a day <br />weeks per pear <br />LIST OF PRODUCTION (check all that apply) <br />Coal (~() Gold ( ) Gem Stones ( ) Lead ( i <br />Silrer ( ) Molybdenum ( ) Zino ( ) Cadmium f ; <br />l.'ranium ( ) Vanadium ( ) 011 Shale ( ) Copper t ) <br />Tungetcn ( ) Tourist ( ) Rack ( ) 1 ) <br />State where inoorporated <br />President/Partner 1 <br />Vioe President/Partner 2 <br />Secretary/Partner 3 <br />Treasurer/Partner 4 <br />Section (?L~) <br />o ~-O . <br />N~ <br /> <br />SHCONDARY CON'TRACTOR'S ;iection Irp) <br />?lame Lf.WO.w f+Rr( /cf~ic~rt«w~7rswJ ' <br />Address o7 S. ui, on 2a~,ee~ <br />ZIP <br />Telephonr_ ( /O3) 7FS-- 730 <br />Date of this r port 3-9^~j <br />Signature _ <br />Title DPR%dA-7~a./f `~~• - ~~(,y <br />Name ~~i?K /G3R>P ! ti. <br />'~~ ~ 53 . <br />t~° a 3~ <br />~~ ~ r o <br />5~h <br />