Laserfiche WebLink
y • <br />Appendix A. <br />APPLICANT'S QUESTIONNAIRE TO THE COLORADO DIVISION OF WILDLIFE <br />For Limited Impact Operations <br />(Permit 110-1 and 110-2) or <br />Regular Operations Permit 112) <br />Instructions to the a licant: Complete both sides of this form. Send the <br />comp el~fe~o a appropriate Division of Wildlife (DOW) Regional Manager. <br />Regional Managers: <br />NW Region: 711 Independent Avenue Grand Junction, CO 81505 <br />NE Region: 317 W. Prospect Avenue Ft. Collins, CO 80526 <br />Central: 6060 Broadway Denver, CO 80216 <br />SW Region: 2300 5. Townsend Avenue Montrose, CO 81401 <br />SE Region: 2126 N. Weber Colorado Springs, CO 80907 <br />To expedite processing, please provide the information in the format and order <br />described in this form. Type or print clearly. Incomplete questionnaires will be <br />returned. Please allow 30 days for processing of completed form. Your cooperation <br />is appreciated. <br />PLEASE ATTACH THE FOLLOWING INFORMATION TO THIS FORM: <br />A. Mining and Reclamation Plan: Description of proposed reclamation plan or <br />su~riit Mining and Reclamation Plan as prepared for MLRD application. <br />B. Mapps: Submit copies of maps for the both the Mining Plan and the Reclamation <br />Flan. Suggested maps are those prepared for the MLRD application. <br />For the 110-1 Permit, Two Acre Limited Impact Operation: Exhibit A - Location <br />Map Exhibit C - Affected Lands Map. <br />For the 110-2 Permit, Limited Impact Operation: Exhibit E - Mining Plan Map <br />and Reclamation Plan Map. <br />For the 112 Permit, Regular Operation: Exhibit C - Pre-Mining and Mining Plan <br />Map(s) of Affected Lands, and Exhibit F - Reclamation Plan Map. <br />- - - - - - - - - - - - - - n- - - - - - - -I - <br />1. Operation name (pit, mine): Wh; fie, K.~ucf SLtnC1 a ~nr'aue <br />2. Application type (check one): Two Acre Limited Impact Operation (110-1) <br />limited Impact Operation (110-2) <br />n~_Regular Permit Operation (112) <br />3. Name of applicant/operator:- l'~env~T ~Le`ntP~ <br />Address: `Q.O,(„ ~~ P'1~ ~ U ~ z ~,a ~ T <br />Phone Number: ,30~-~~4'~15~ y- <br />4. Name of contact person (if different from above):~~~gyZ y ,/~f"~ S efj <br />Address: 7 <br />Phone Number: <br />5. Location of mine: {~'jp ~(CLr~Co l..o. e~l'~~B~w o!Y' i,t, /OL[IiZ.YCVl, <br />(County, Township, Range, Section to ngarest quarter quarter <br />(OVER) ~An~ 9`'~ l~Jtct °J (~v ~o~ 1°1N. <br />-10- Q <br />