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Application Form for a Permit <br />to <br />Conduct Coal Mining in Colorado <br />State of Colorado Application to conduct surface <br />Department of Natural Resources or underground coal mining <br />MINED LAND RECLAMATION DIVISION activities or other sur_`ace coal <br />1313 Shezman Street, Room 423 mining and reclamation operations <br />Denver, Colorado 80203 (303)839-3567 in Colorado pursuant to CRS 1973, <br />34-33-101, et. se . <br /> <br /> <br />For an application to be deemed complete by the Division pursuant to CRS 1973, <br />34-33-Z 03 (5) and Rule 1.04 (30), an applicant must: (1) supply all information as <br />specified on this application form; (2) submit five reproducible copies of the permit <br />application with original signatures; and (3) pay the appropriate fee required by <br />Rule 2.01.6. <br />Please note that this form is only a Listing of general cetegory requirements and <br />does not constitute a checklist of detailed permit application requirements. A <br />finding of completeness should not be interpreted to imply adequacy of an appli- <br />cation. Addtional information not listed on this form may be required For adequacy <br />depending upon the individual circumstances of an application. <br />This form consists of two major parts: (1) a section entitled General Operation <br />Information and (2) a section entitled Application Requirements. Specific instruc- <br />tions for :filling in the necessary information for each section appears immediately <br />below the title of each section. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly the appropriate information as listed below. Supplemental <br />sheets may be used as necessary, such sheets must be attached to the form and re- <br />ferenced ,or keyed to the numbers on the form. <br />1. Name of operation <br /> <br />(Pit, mine or site name) Peacock Coal Mine <br />2. Name of Applicant <br /> (Name to be used on permit - Sun Belt Mining, Inc. <br /> the permittee) <br />2a. Address and phone number of 3701 County 120 <br /> local offices H~SPeruS~-Cq~~rado 131326 <br />it <br />i <br />l. <br />i <br />0 <br />3 <br />2b. Address and phone number of ne Highway, Suite 20 <br />i <br />71 <br />0 Gr <br />a <br />pev <br />0 <br /> general offices. Fort Worth, Texas 76118 <br /> 1 589-7026 <br /> <br />3. Name and phone number of person S.D. Stevens <br /> staff members should contact (303) 385-4377 <br />4. Parent Corporation, if any I Sun Belt Petroleum, Znc. <br /> (Include name and address) 7100 Grapevine Highway, Suite 2C <br /> Fort Worth, Texas 76118 <br />8 <br />i8 <br />