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;,,, _ 7r7a <br />IMITED IMPACT (110) and <br />SPECIAL TEN-DAY (111) PERMIT <br />APPLICATION FORM <br />State of Colorado ~~~~~~~ <br />Department of Natural Resources <br />MINED LAND RECLAMATION BOARD ~y1 <br />1313 Sherman Street, Room 723 S EP - 6 T~19 <br />Denver, CO 80203 (303) 839-3567 <br /> <br />;tt jj D 99g <br />~4 ~~~~ SJ <br />Application far Mining and <br />Reclamation Permit, pursuant <br />to CRS 1973, 34-32-101, et seq <br />___ MINED LAND RECLAMATION <br />COI o. Oept. of Naturzl Resources <br />The following explanations cover Limited Impact applications (110s) and Special (Ten- <br />Day Processing)(llls) applications. !n the interests of efficient processing, please <br />check the appropriate box to indicate which type of application you are applying for here <br />' X LIMITED IMPACT OPERATIONS must disturb LESS THAN ten acres (including <br />all roads, stockpile areas and any other surface facilities) over the <br />life of the mine, and must extract LESS THAN 70,000 tons of mineral, <br />overburden or combination thereof per calendar year. If the affected <br />area is some fraction greater than nine acres, be sure NOT to round this <br />figure out to ten acres in the narratives or elsewhere. <br />SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN ten acres <br />(including all roads, stockpile areas and any other surface facilities), <br />and can ONLY be obtained where a federal, state, county, city, town or <br />special district contract calls for work to be commenced within a <br />SPECIFICALLY SHORT TIME. <br />F-~~. No. 79-~~~ <br />- (Type or Print Clearly) <br />1. Name of operation ~ ~•~~el,pperatian <br /> (Pit, mine or site name) <br />2. Name of applicant/operator ~,~, <br /> (Name to be used on permit) <br />3. Address and phone number of .~ ~IZ..II r t -a~ q~~,~ <br /> local offices <br />303..._ 824-7631 <br />4. Address and phone number of Same <br /> general offices <br />5. Name and phone number of person ~,~„ ,~„~~ , <br /> staff members should contact <br />6. Owner(s) of record of affected <br />land (surface area) (If more <br />James W. Morbray and Inza Mowbray, in joint <br /> than 2, list below) <br />tenancy. <br />7. Owner(s) of substance to be mined Same <br /> (If more than 2, list below) <br />8. Source of legal right to enter <br />(Indicate what type of proof is <br />Co ies of Deeds Se E <br /> included in EXHIBIT G - lease, <br />deed, notarized letter, etc.) <br />9. Tyoe of mine b substance to be <br />mined (Specify underground, strip, Open Pit - <br />~B.i~ar Aun 6savel <br /> open pit, etc. & substance(s) to <br />be mined) <br />10. General location & elevation <br />(Miles E direction from nearest <br />.~~r..~r ~'3"~# <br /> town E approximate site eleva- <br />t i on) ,~~ ~, yg ~.~-y~ _ Elevation 4~~9 fePt. <br />11 . County -~e1rta 6eerrty <br />12. Acreage of affected lands <br />(Total surface acreage to be <br />included in ermit <br />--q, T5 Acres <br />13• Application fee (See applicable <br />RULE to determine amount) <br />-Jp~La2.50 <br />(over) <br />~~.ya <br />