REV95711

• Permit No: M1973021
• IBM Index Class Name: Revision
• Doc Date: 11/14/1994
• Doc Name: REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM4
• Media Type: D
• Archive: No

-s-
• 10. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: Rick Mergens
Company Name: Coolev Gravel Comnanv
Street: 3609 South Wadsworth Boulevard. Suite 300
City: Lakewood
State: Colorado Zip Code: 80235
Area code: (303) Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: CAMF
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT'
individual's Name: SAME
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDBRAL LANDOWNER (if anvl
Agency: N/A
• Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATB OR FHDERAL LANDOWNER (if anv)
Agency: _ N/A '
Street:
City:
State: Zip Code:
Area Code: Telephone:
11. Primary future (Post-mining) land use (check one):
_ Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA)
_ RangelandlRL) _ Foreetry(FR) _ Wildlife Habitat(WL)
Residential(RS) Recreation(RC) Industrial/COmmercial(IC)
~ Developed Water Resources(WR) _ Solid Waste Dieposal(WD)
12. Primary resent land use (check one):
_ Crop and(CR) _ Pastureland(PL) General Agriculture(GA)
Rangeland (RI,) _ Forestrx (FR) ~ Wildlife Habitat (WL)
Residentisl(RS) _ Recreation(RC) _ Industrial/Commercial(IC)
_ Developed Water Resources (WR)
13. Method of Mining: ~ Quarry (QR) _ Solution (SO)
13.1 Other: Briefly explain mining method (e.g. Placer, truck/shovel).
Drill. blast. load (shovel/loader). ha ~l. (50-ron rnrkl rri~sh. May alcn
14. On Sites~rocePesinaobile crusher ~onl~tfl~eHl d(~nveyors.Chemical (CH) Thermal (TH)
_ Heap Leach (HL) -_ Vat Leach (VL)
N/A
~ist any designated chemicals or acid-producing materials to be used or stored within permit
area: