Laserfiche WebLink
CHECK ONE <br />~.tv~5-n--~,•P~'" t~ ~ M _ -~ S - 33 ~ III IIIIIIIIIIIII III <br />sss <br />DEC 41992 <br />TWO-ACRE LIMITED IMPACT OPERATION (110(1)) <br />RECLAMATION PERMIT U~b iS ~;;~, <br />APPLICATION FORM `iINER4L~ ~ ~:~ , <br />_ New Application (Rule 3.3) Amendment Application (Rule 1.8) <br />c Conversion Application (Rule 1.10) <br />The application for a Two-Acre Limited Impact Operation Reclamation Permit shall contain <br />three mayor parts: (1) the application form, (2) Exhibits A-H, and (3) the application <br />fee. When you submit your application, be sure to include one (1) original signed <br />application and one (1) copy of the application form, two (2) copies of Exhibits A-H, <br />and a check for the application fee described under (3> below. To expedite processing, <br />please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION ~}'/-7~ ~3o`L <br />Type or print clearly, in the space provided, all information described below. <br />Co low R.~ ~ c~-~n.E-«n.. <br />1. Applicant/operator name: (ZOCkY in7n1 rzos~ IZ-1'r~ 1-JC,. <br />1.1 Type of organization (corporation, partnership, etc.) C,OR Q , <br />C'v !ox IPasc ~' Pi ~ <br />2. Operation Name (pit, mine or site name): CY~W fZ~E. (~.d~ Ci2A~i'f1L.C~)yom.~e.Y <br />2.1 IRS Tax ID No. or Social Security No.: <br />3. Permitted Acres: ~%q, permitted acres <br />3.1 Application fee: (New Application Only) 5250.00 application fee <br />4. Substance(s) to be mined (e.g., gold/silver): S-~2ANITf~ 6~OCkS <br />5. Name, address, and phone number of the owner of the surface of the affected land: <br />DA1J i-.I ~S~/fr.~.D n1orCH STAR IZ'!- LYOnJS Coco • ir'OSztD <br />6. Name of owner of subsurface rights of affected lands: SAn~~ /kS AT3 a~E <br />7. Type of mining operation: ~ Surface _ Underground _ In-situ <br />8. Location Information. The center of the area where the majority of mining will <br />occur lies in: <br />~~ ~.b{~}N~~~ COUNTY: L,ARIMi`R <br />PRINCIPAL MERIDIAN (check one): 6th (Colorado) <br />TOWNSHIP (write number and check direction): T ~• <br />RANGE (write number and check direction): R <br />SECTION (write number): S ~'~ <br />QUARTER SECTION (check one): _ NE <br />QUARTER/QUARTER SECTION (check one): _ NE <br />GENERAL DESCRIPTION: <br />10th (New Mexico) Ute <br />X North _ South <br />East West <br />_ NW X SE SW <br />_ NW _ SE _ SW <br />(miles and direction 1.10 C~4tiJC~I~. F~OIYI ~XLSTIIJC~ <br />from nearest town and <br />approximate elevation) PF.Kf'11T l LO CZ~ <br />