2006-03-17_REVISION - M2003030

• Permit No: M2003030
• IBM Index Class Name: Revision
• Doc Date: 3/17/2006
• Doc Name: 110‎(s)‎ application
• From: Joseph L. Dorris
• To: DMG
• Type & Sequence: AM1
• Media Type: D
• Archive: No

~~` STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
Department of Natural Resources
1313 Sherman St, Room 275 !~ A ~ ~ C O L O RAD O
Uenver, Colorado 80203 //~1/(/I ~O DIVISION O F
Phone: [phone] MINERAL S
fAX: [phone] G E O L O G Y
LIMIT•EDIIKPACTOPERATION(110(2}) ~EC'~'~'¢~® 0.ECLAMATiON•nINING
SAFETY•SCIfNCE
RECLAMATION PERMIT ~ MAR 11 2006 "
8i11 Owens
APPLICATION FORM ovemor
~iaision aI Minerals and Gealog~yi ~~
Executive Director
. / Ronald W. Cattany
f:HF//('x//f--NQF.; V New Application (Rule 1,.4)/ Conversion Application (Rule 1.11) Division Director
Li C.~%Jl D.~7~lt o!'S/~~f#.9cir- ~r~ Natural Resource Trustee
Permit # M- 2-pO3 _ U3 n (provide for conversions of existing permits)
The application for a Limited Impact Designated Mining Operation Reclamation Permit contains three major parts: (I} the
application form; (2) Exhibits A-J, any required sections of Exhibit S and Geotechnical Stability Exhibit, as required by the Office,
and outlined in Rules 6.1, 6.2, 6.3, 6.4.19 and 6.5; and (3) the application fee. When you submit your applipflon, be sure to include
one (1} 5ignerl And nnrattiz~ original and one (1) colry of the applipion form, two (2}copies of Exhibits A-J, appropriate sections of
6.4.19 Exhibit S and 6.5 (Geotechnical Stability Exhibit), as required, and a check for the application fee described under (4) below.
Exhibits should nu! be bound or in a 3-ring binder; traps should be folded to 8 I/2" X 11" or 8 1/2" X 14" size. To expedite
processing, please provide the information in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, all information described below
1. ApprirnnUnnerarnr nr rn~ayy name (name to IM nwi nn the•~prmitl~ `'°`~OS TPL ~ .IJ+~~ !-S `~
I.1 Type of organization (corporation, partnerslip, etc.): 5°~ _ ~~,o,'>Ct°i'
1.2 I.RS. Tax ID No.: S! f3 - (a 2 - fly ~ 7
2. fl!rwratinn name (~ minP nr Rite ram 1• ~/aC+['/ Pd a /' /~/A/nQ
7
3, PPrmittPd arrea~ (new nr eii"fing ai Pl• 9, 9~ perQli~ a~reS
4. EceB:
4.1 New Application SR75 (>n application fee
4.2 Conversion Fee {from 1104 to 110(2), {Rule 1.112(2)) ~R75 f)0 conversion fee
5. Priman, rrEmmnditiPlS) to hP mined• L!/~7 X30/, ~/~, s//J~~ ~yd~' ~3~ee%~dl~f~ m:~Cf~/s
(, Name of nwnrr to the carfare of affPMPd land• U• S - ~:-•rO''~~/fir [J ~j(r,\'t'' oaf,. 5 . •}-orPS ~t Sir/i f.~' _
], Name of nw11Pr }n the rOEhanrfaCP rl4ht4 r1f affPrtPd IAnd• -1 OJCDF'I L • L Ji vC /S
--l
$, 'I,~oe of miningnperatinn~ ~ Stt[face
Underground ~ In-situ
Office of Office of Colorado
Mined Wad Reclamation Active and Inactive Mines Geological Survey