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<br />10. Correapottdence Infamaiore <br />APPLICANT/OPERATOR: (name, address, and phone of name to be used an permit) <br />Contact's Neme: Themes Hartk~. Atilna MIB Mattuetr Gwen Fraser. Pre sltleot <br />Company Neme: COM. Inc <br />Street PO Bas 17704 3740 W. Mardmd Wa S.W. <br />City: Bealder Seattle <br />Sffite: CO 80308-0704 WA 98106 <br />Phone: (303)449-7746 <br />PERMITTING CONTACT (if different from applicartUopetator above) <br />Individual's Name: shames Huller Title: ~ MW Msmasr <br />Company Name: COM_ lur: <br />Sheet: PO Bo:17704 <br />City: Boulder <br />Stele: CO Zip Code: 1fi070~0704 <br />Area Code: 307 Telephone: 449-7716 <br />INSPECITON~ONTACT <br />individtal's Nerve: Thames Has1Mr Title: AeUaa MO 111atsaas <br />Company Name: C.O.M. Ioe. <br />Street i'O Boz 17301 <br />City: Boulder <br />State: CO Zip Code: 807801-03M <br />Area Code: 703 Telephone: 449.7716 <br />CC: SPATE OR FEDERAL LANDOWNER fifanv) <br />Agency: Bmeao of Land Matsaeemwt <br />Street 3170 East Mom Sfroet <br />City. Camas (.'ll= <br />State: CO lip Code: <br />Area Code: Telephone: <br />CC: STATE OR FEDERAL LANDOWNER Gf env) <br />Agertcy: <br />Street: <br />Cdy. <br />State: <br />Area Code: <br />Telephone: <br />tiP Cade: <br />11. Primary future (Post-mininc) lend ux (check one): <br />_ Cropland (CR) -Pastureland (PL) _ General .~ictdlure (GA) <br />_ Rangeland (RL) _ Forestry (FR) ~ Wrldtife Habitat (WI.) <br />_ Residential (RS) _ Recreation i RC) _ indtahieVCommerciel (TC) <br />_ Developed Water Resources (WR) _ Solid Wavle Disposal (WD) <br />l2. Prinary prima tt land use (checJc one) <br />CropLnd (CR) _Pashaelend (PL) _ General AgricuNrrte (GA) <br />Rangeland (1tL) _ Foresuy (FR) _ Wtldfit'e Hsbuat (WL) <br />Reaidenfiel (RS) _ Receatian (1iC) ~ indtattieUConnnadal (1'C) <br />_ Developed wait Resouroes (WR) _ Mirtitg (!~ <br />l3. If this operation will use designated chemicals, m wi8 resuC, err pstaattly has cad mine drainage - You ~ tae this <br />application form. You must submit either a 1104 or 1124 eppliatiat form for Desigrated Mittmg Opae6one. Tn either <br />case, You mtat fist any acidic a to>orrfommtg rmterisls, atpaed or disturbed as a fault of the ~8 operation, acrd <br />whether the operation will result in, or presently has acid mine draitage: <br />Description of('onvertrion: <br />If you aze converting an erdating operation, provide a brief naaative deambirtg the psopoeed c}uttge(s). <br />2~ <br />