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,.-~- ~~ <br />LIAQ'I ~~~ ~~~~~~~~~~~~~ ~~~ ,N ~,,• RECEIVED <br />1 -- _ sss_.. _ .......IT 14 <br />wPPLIGIION FORM JUL 21 1995 <br />CHECK ONE: _NewApplicatiat (Ruk 1.4) _ConvermonApplicstion (Rule 1.11) Division of Minerals & Geology <br />Permit k M - (provide far oonversona of exietirrg penrrita) <br />The application far a L®ifed Impact Deaigrreted Mumrg Operation Reclamation Pemrit contains three major parts: (1) the <br />application fond; (2) Exhdbitn A•l, arty rcquaed sectiarrs of Exhibit S and Geotcehnical SlabOity Exhibit, as required by the <br />Office, end outlined in Riles 6.1.6.2, 6.4.19 end 6.5: end (3) the application tee. Whin you submit your appiicetiotr, be sine <br />to inohrde one (1) simred and rwtarized arigirral and ante (1) Dopy of the application form. two (2) copies of Exhrbits A-1, <br />eppmpriete sections of 6.4.19 F.xtnbit S and 6.5 (Geobechrtitxl Stability ESchtbit), m rapured, and a check for the application <br />fee deaonbed undo (4) below. Exlubils should not be boturd err vt a ~mtg binder, maps should be folded to 8 1/2^ x 11" or 8 <br />t/2^ x 14^ ~. To expedite prooes~rg, Please provide the urfo~ation in the format end order desearbed irr this form. <br />GENERAL OPERATION INFORMATION <br />~'Pe or P~ ~Y. ~ the space provided, ed infoaiation deacdbed below. <br />1. Applicertt/operstor or company name (name to be used an pemrit): <br />COM. Ise. <br />1.1 Type of orgarri~timr (corporation, pettrtership, eto.): Carwatlw <br />1.2 IRS Tax ID No. or Soaal SecurAy Number. <br />2. Operation name (pif, tttine, m si6e rums): Gall l~ MIY <br />3. Pemritied acreage (trees or existing site): 6.20 pemritted acres <br />3.1 Clrenge at aereage (+ or •): +2.20 acres <br />4. Faea: <br />4.1 New Application 1875.00 application fee <br />1.2 Conversion Fee (from 1 lOd W 110) (875.00 conversion bee (Rule 1.! 1.2(2)) <br />5. Primary conioodity (ua) ib be mined: Sra d $~ <br />6. Name of owner to the subsurface righa of nffetr6ed land: COM. Le. <br />7. Nerve of owner to the surface of affected land: COM. Inc. <br />8. Type of mhturg operation: X Stifaoe _ Uttdergrotard _In-sir (M01sv <br />9. Loation arfmmetiorr. The center of the area where the majority of mirrirrg will oocra lies cr: <br />COUNCY @thtNrr <br />PRINCIPAL MERIDIAN (check one): ~ 6t6 (Colorado) _ 10th (New Merdco) _ Ute <br />SECTION (writenrmrber): S IZ <br />TOWNSHIP (write number and check di[ection): T 1 ~iC North _ South <br />RANGE (write ntmrber acrd check diectian): R 7Z _ Eeat J~ West <br />QUARTER SECTION (check one): _ NE J~ NW SE _ SW <br />QUARTER/QUARTER SI.C1iON (deck area): _ NE _ NW X SE _ SW <br />GENERAL DESCRIPTION: (~ end direction from nearer town and approxhiete elevation): . <br />8.tl8 feet elevafloe. 10 sYes evert d liooldrr. CO. ElevaUao 8550 to ttf00 red <br />