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<br />pF CO~p <br />AF' = Y <br />hem <br />.k~~~$ COLORADO DIVISION OF MINERALS AND GEOLOGY <br />]313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />~lg~6 ~` <br />RFt^,FfyFD <br />APPLICATION FORM ~+~~L 1 9 2~~~ <br />RENEWAL OF A VALID, EXISTING PERMIT <br />TO CONDUCT MINING IN COLORgi~jpisionofMineralsdGeology <br />This form is an application for successive renewal of a valid, existing permit to conduct surface or <br />underground mining and reclamation activities or other surface coal mining and reclamation operations <br />in Colorado pursuant to C.R.S. 34-33-101, et seq. This application form is designed to revise and update <br />the application form currently included in your permit application. The right of successive renewal <br />applies only to lands and activity which were permitted during the previous term. Extensions of the <br />permit area and significant new activity within the permit area are subject to the review procedures <br />applicable to new permit applications, in accordance with Rule 2.08.5(1)(c) and 2.08.4. <br />For a renewal application to be deemed complete by the Division pursuant to C.R.S. 34-33-109(7), an <br />applicant must submit: (1) all information as specified on this application form; (2) a copy of the <br />newspaper notice; (3) evidence that a liability insurance policy will be provided for the proposed period <br />of renewal; and (4) five reproducible copies of the permit renewal application with original signatures. <br />For federal mines, a copy of the renewal application must be submitted to all agencies on the federal <br />agency mailing list at the same time the application is submitted to the Division, and proof of distribution <br />must be submitted to the Division. Copies of renewal pages modified during the review process must <br />be distributed in the same manner, along with proof of distribution. Proof of distribution must be <br />submitted prior to implementation of the renewal. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly the appropriate information as listed below. Supplemental sheets may be used as <br />necessary. Such sheets must be attached to the form and referenced or keyed fo the numbers on the <br />form. <br />1. Permittee: COaSd~'!l'P t`.Qp/ Ly~11hlp~y~/. -L,rJG. <br />2. Name of Operation: ~QS~~S/o!B ~i//yJ~ <br />3. Permit Number (same as current permit number): C -8 ¢- 6~ <br />4. Type of Revision: R N Renewal Number: 0 <br />5. Application Submittal Date: D7/ ~~'/4~ <br />