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00/26/1999 08:17 303-702-0398 <br />GENERAL PERNIIT' APPIYCATION <br />ST'ORMWATER DISCHARGES <br />ASSOCIATED WITFI: <br />LIGHT IIVAUS11i;IAL ACITVTI'Y <br />(Pantlt No. COR-010000) <br />STsAVY INIDT)5'11tIAI.. ACTIVITY <br />CIMi W(~CD 41000 <br />PAGE <br />02 <br />(Ptsmit No. COR-020000) <br />METAL MRVIItTG (Permit No. WR-040000) <br />Pkaae print or type. I>o tint atnznpt t0 complete this form beforo teadhg the iostrtx~iont:. <br />1. Name tmd adth+ras ~ permit apptkant: <br />Compaty Nsttte: ~- <br />/~- <br />f VI 3 <br /> <br />Fedarai T}zpRyer (or Banployt:r) ID/: ~ ~ - O G r,Y `~ ,~ 3 9 <br />Mailhtg Atldtesa• 13 / 3 S lie /t n-rT. S T N ~• a- t f <br />City. State aad Zip Code: ~G ~.vc/L, C ~ lv2A-Ov ~ 0Z~3 <br />.___. , <br />Phone Number: { 303 1 Sfs'G- 3S'6 <br />Title: /tu ~c c f ~"~'~~~7//Ini~G'L2 <br />2. Lantim of trie cao'tiey: <br />Sttt:et Addreas:~ <br />Clry, State and~Zip Code: <br />Coutny: _~f 1-rCfni <br />Who is applying for the permit? L._i Ottmar I"J Operator <br />Pgtme Ntttnber: (Y 7 y > ~- ¢ / - 03,3 -~ <br />/mss a,~ <br />J <br />Name of facility: Cu.tt. hRS,N Std~hen.t /~u~-O /Ze c Lart,rTie~>' <br />Y.egKi lontion fTownahip, ]large, teaion, 1l4 saxion):Tro S . 2~, R,9!0 f Seo rrotis 6, 8. Io. {~, tc, r~~ a! <br />,. <br />~ /Q7° / i>'r 00~~ 39 ~ /fir 00 q~~ <br />Type of Facility: ^ New (beginaiag operations after lall92) LI Existiap (as of l0/l/92> <br />3. 1#andar~d Indtuttial Cron (~C1 Code(s) for this facility. {Iuclt>de up m four. in order of itupottsace.) <br />awfA CawS[RucTto~/ b) C) d) <br />4. Permit Cata~ory: Under which stotmwater gettetal pettttit does this fact~ity belong? (See Appttndix A.) <br />^ Fleavy Y ^ Light Indoaay ~ Meral Mining (or Coal -see lasexnctiao,e) <br />r«ry, r <br />M'mea only: MLRB permit anniversary date Nan- /te vo rrcQ Which tytegory is your facility Hader'? <br />D Active mine, leas thaa 10 acra ^ wetive mine. 10 atxes ar more ©rnactive mine <br />s. Reodvioy Stream: The aatae of the rxeivini sttasm(a>• (If discharge is to a ditch or storm sewer. also roelude the <br />name Of the Wtlmate mceivi:og worsts). Hutt G cQro tr , C v~'L [/1 ~~ FT _ <br />7/96/ILn <br />-1- <br />e <br />v. <br />a <br />c <br />n <br />C <br /> <br /> <br />