_PERMIT FILE - M1980194 ‎(4)‎

• Permit No: M1980194
• IBM Index Class Name: Permit File
• Doc Name: LIMITED IMPACT 110 & SPECIAL TEN DAY 111 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

LIMITED IMPACT (I10) and III IIIIIIIIIIIIIIII
•PECIAL TEN-DAY (111) PERMIT 999
APPLICATION FORM
State of Colorado Application for Mining and
Department of Natural Resources Reclamation Permit, pursuant
MINED LAND RECLAMATION BOARD to CRS 1973, 34-32-101, et seq
1313 Sherman Street, Room 723
Denver, CO 80203 (303) 839-3567
The following explanations cover Limited Impact applications (110's) and Special (Ten-
Day Processing)(111's) applications. In the interests of efficient processing, please
check the appropriate box to indicate which type of application you are applying for
here. 111 permits may be issued only under special circumstances. Be sure you are
eligible.
LIMITED IMPACT OPERATIONS must disturb LESS THAN ten acres (including all
1! roads, stockpile areas and any other surface facilities) over the life of
the mine, and must extract LESS THAN 70,000 tons of mineral, overburden or
combination thereof per calendar year. If the affected area is some fraction
greater than nine acres, be sure NOT to round this figure out to ten acres in
the narratives or elsewhere.
SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN ten acres
(including all roads, stockpile areas and any other surface facilities) ,
and can ONLY be obtained where a federal, state, county, city, town or
special district contract calls for work to be commenced within a SPECIFICALLY
SHORT TIME.
(Type or Print Clearly)
1. Name of operation See attached list
(Pit, mine or site name) E1 Paso County Gravel Pits b'o -1J416.,, Su -J'[b
2. Name of applicant/operator E1 Paso County
(Name to be used on permit) Department of Transportation
3. Address and phone number of 3170 Century Street - 471-5445
local offices Colorado Springs , Colorado E0907
4. Address and phone number of 27 East Vermijo Street
general offices Colorado Springs , Colorado 80903 - 471-5712
5. Name and phone number of person Max L . Rothschild
staff members should contact 471-5445
6, Owner(s) of record of affectedland See attached list
(surface area)(If more than 2, list below)
7. Owner(s) of substance to be mined See attached list
(If more than 2, list below)
8. Source of legal right to enter
(Indicate what type of proof is See attached contract forms
included in EXHIBIT G - lease,
deed, notarized letter, etc.)
9. Type of mine S substance to be
mined (Specify underground, strip, Open pit - gravel and dirt
open pit, etc. 6 substance(s) to
be mined)
10. General location 6 elevation See attached maps
(Miles 6 direction from nearest
town S approximate site elevation)
!I. Oocnty E1 Paso
12. Acreage of affected lands
(Total surface acreage to be
included in permit) All under 10 acres
13. Application -lee (See applicable
RULE to determine amount)
14. Present land use (i.e. , agri- A riculture - Range Land
cultural, industrial, etc. )
15. Proposed future land use �Akriculture - Ran1;e Land
(Goal of reclamation)
(over)