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LIMITED IMPACT AND SPECIAL (TEN-DAY) <br /> PE..MoffT APPLICATION FORM I� <br /> 1ATE OF COLORADO Application for Mining <br /> Hined Land Reclamation Board RECEIVED and Reclamation Permit, <br /> partment of Natural Resources Pursuant to C.R.S. 1973, <br /> 23 Sherman Street, Room 723 SUN 122 1978 34-32-101, at seq. <br /> Denver, Colorado 80203 <br /> ' .E' qN p, &CtN14 i rN <br /> LIMITED IMPACT OPERAT7 � e���.ui ����e���c�s�'� ten acres (including all <br /> roads, stockpile areas and any otie= surface facilities) over the life of <br /> 1 the mine, and must extract LESS THAN 70,000 tons of mineral, overburden <br /> or combination thereof per calendar year. If the affected area is some <br /> fraction greater than nine acres, be sure NOT to round it up to ten acres <br /> ' ist the narratives or elsewhere. <br /> SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN ten <br /> ' acres (including all roads, stockpile areas and any other surface <br /> facilities) , ane can ONLY be obtained where a federal, state, county, <br /> city, town, or special district contract calls for work to be <br /> ' commenced within a SPECIFICALLY SHORT TIME. �t <br /> TYPE OR PRINT CLEARLY l ' al <br /> '. Name of operations Shaffers Crossing <br /> (Pit, mine, or site name) <br /> Name of applicant/operator Nelson Contractors, Inc. <br /> (Name to be used on permit) <br /> Excavating Contractors <br /> Address and phone number of 10221So. Highway 73 Conifer, CO 80433 <br /> local offices Phone 674-3919 <br /> Address and phone number Some os Above <br /> of general offices <br /> Name and phone number of person Larry Nelson <br /> staff members should contact Phone 674-39 9 W70 <br /> Owner(s) of record of affected Nelson Concrete Pumping, Inc. <br /> land (surface area) <br /> (If more than 2, list below) <br /> 7. Owner(s) of substance to be mined <br /> (If more than 2, list below) <br /> 8. Source of legal right to eater Notarized letter-See Exhibit G <br /> ' (Indicate what type of proof is <br /> included in Exhibit G - lease, deed, <br /> notarized letter, etc.) <br /> ,9. Typo of mine & substance to be mined Quarry site-material excavoted will be used for <br /> (Specify underground, strip, open pit, road base & gravel for asphalt paving <br /> etc. and substance(s) to be mined) <br /> 10. General location & elevation (`tiles At the southeast corner of Shaffers Crossing and <br /> & direction from nearest town 6 <br /> US Highway 285 <br /> approximate site elevation) <br /> 11• County .Jefferson <br /> 12. Acreage of affected lands 9.92 Acres <br /> (Total surface acreage to be <br /> included in permit) <br /> 13: Application fee (See appllcab'_e Rule $125 <br /> to determine ar-ount) 1 <br /> I <br />