PERMFILE102154

• Permit No: M1981121
• IBM Index Class Name: Permit File
• Doc Name: LIMITED IMPACT 110 & SPECIAL 10-DAY 111 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

LL•lITED L`~1ACT (110) and
5PECLLI.},T,f.V-D,1? .(111) '~Z`SIT
State of Colorado
Department of 5atural Resources ~~~,~~ ~~~~~
:2VED L?ND REC•..1`+~TION BOARD
1313 Sherman Street, Roam 423 .y..i_,:- NQ,R
Deaver, CO 80203 [phone] ~ti„ ~ ''
~ ~~~ lll~~ll~~~
~~~° a 999
a,
~' ~ L
Application for ?Siaing aad
Reclamation 2ermic, pursuant
to CRS 1973, 34-32-101, ac seq
e. ~~v~ ~ ~- 1 ~ I~
The following explaaatioas cover Limited Impact applications (110'9) aad Special (Ten-
Day Procassiag)(IlI's) applications. La the interests of efficient processing, please
chec4c the appropriate box to indicate which type of application qou are applying for
here. 111 permits may be issued poly under special circmastances. Be sure you are
eligible.
LL~ffTED '.`!PACT OPERdTI0N5 must disturb LESS T6Aa`I tea acres (including all
roads, stockpile areas aad nap other surface facilities) over the life of
the mine, aad must extract LESS THA2I 70,000 tons. of mineral, overburden or .
combination thereof par calendar year. If the affected area is same fraction
greater chaa nine acres, be sure NOT to round this figure out to tan acres is
the narratives or elsewhere.
SPECIAL (Tv.St-DAY PROCESSING) operations must disturb LESS THA2I ten acres
(including all roads, stockpile areas aad nay other surface facilities),
and can ONLY be obtained where a federal, state, county, city, town or
special district contract calls for wrk co be commenced within a SPECZc-ICALLY
SHORT TZ:~.
(Type or Print Clearly)

1. name of operation Earl L. Hale ~L ~} 2 ;-r- ~~
(P±t, mine or site Hama) SitQ address 10675 DcClelland Road
2. :tame of applicant/operator Earl L. Hale
(Name to be used on petait}
3. Address and phone number of 7595 California D i
local offices Colorado 80908 Telephone [phone]
4. Address and phone number of
;eaeral offices
i. Name aad phase number of person Earl L. Hale 495-2592
staf_° members should contact
6, Owner(s) of record of affected and I Earl L. Hale
(surface azes)(T_f more chaa?, 1st below)
i. Owner(s) of subscaaee to be mined
(If note thaw 2, 119E below}
8. Source of legal right to enter
(Indicate what typo of proof is Fee title
included is E~IBIT G -lease,
deed, notarized latter, etc.) See Exhibit G 1981 Tax Bill
9. Type of mine S substance to be
mined (Specify uaaergrouad, strip,
Sand and gravel from open pit mine
open pit, etc. S substance(s) co
be 3iaed)
10. General location S elevation
(Pil
S di
i
f About 25 miles East of Colorado Springs
es
on
rom nearest
rect
eown S appro + ce site elevation)
Elevation about 5600 feet
Il. Canney E1 Paso
iZ. Acreage of affected loads
(Total surface acreage to be
included is permit) About 9.9 acres
13. Anplicaeion fee (See applicable ~
ROLE co decermiae amount) prS~/Q
$25.00 plus$99.00 or $124.00 ~ a~
1:. Present Land use (i.e., agri- A ricultural
- cultursl, iaduscr'_a'_, etc.)
l.i. Prcoosed future land use Restore to agricultural use by refilling
(Gael of reclamation) ~ and re-sodding

(ever)