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<br />LIMITED TPIPACT (110) and
<br />TEN-DAY (111) PERMIT
<br />=,~n......,,:,.. APPLICATI90N FORM
<br />III III III IIIIIIIIII
<br />of Colorado -~~'.~': ~7og,~ A cat3 n ,fo ning and
<br />' . Ku.r` w nom'
<br />tment of Nate `,'7~, - , pursuant
<br />LAND R6CLAMATIE1~j ~~ ~ ~j i ~+.'~ tri ` $ 1973, 3 ~3 -301, et seq
<br />Sherman Street, R$em 7Y3 ,, I IG.L.J ~t
<br />r , CO 80203 (303) 839-3Sb7 `' Y .. - • ~" (~, - ~l o , ~ ~, - o~ oZ
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<br />The following explanations cover Limite~ Impac~8 applications (110's) and Speu'ial (Ten-
<br />Day Proaessing)(111's). applications. In the interests of efficient proces~sis}g, please
<br />check the epgropriate box to i~~~'~lt~cYk(t~j¢d of`~~plication you axe aPP~~~1}~ing for
<br />here. 111 permit8 may be iss~fcdoo~ undesiuspeoi~aL~ul~•cumstances. Be sure }You are
<br />eligible.
<br />LIMITED IMPACT Ot~RATIONS must disturb LESS THAN ten acres (including;aA1
<br />roads, stockpile areas and any other surface facilities) over the lif ~qf
<br />the mine, and must extract LESS THAN 70,00 tons of mineral, overbard !or
<br />combination thereof ger calendar year. I the affected area is some fralction
<br />greater than nine acr~as, be sure NOT to round this figure out to ten acres in
<br />the narratives or elsewhere.
<br />1-Y SPECIAL (TEN-DAY PROC)35SING) operations must disturb LESS THAN ten ae~es,
<br />L1 (including all roads, stockpile areas and any other surface facilitie ),,
<br />and can ONLY be obtained where a federal, state, county, city, town o~
<br />special district contract calls for work to be commenced within a SPE If'IICALLY
<br />SHORT TIME.
<br />(Type or Print Clearly)
<br />1. Name of operation ~ Gia~SS LIVESTOCK COMPANY. INC.
<br />-t +.
<br />(Pit, mine or site name) ~- rtm
<br />2. Name of applicant/operator
<br />(Name to be used on permit)
<br />3. Address and phone number of
<br />local offices 0 3
<br />4. Address and phone number of
<br />general offices
<br />5. Name and phone number of pex•son
<br />staff members should contact.
<br />g, Owner(s) of record of affected ]and GLASS LIVEISTOCK COMPANY, INC.
<br />(surface areax If more than 2, list below)
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<br />7. Owner(s) of substance to be mined GLASS LIVE TOCK •COMPANY INC.
<br />(If more than 2, list below)
<br />8. Source of legal right to enter
<br />(Indicate what type of proof is
<br />included in EXHIBIT G - lease,
<br />deed, notarized letter, etc.)
<br />9. Type of mine & substance to be
<br />mined (Specify underground, strip,
<br />open pit, etc. 6 substance(s) to
<br />be mined)
<br />!O~ General location & elevation
<br />{Hiles & direction from nearest
<br />town & approximate site elevation)
<br />11~ County
<br />TITLE OPINION BY ATTORNEY
<br />3P Acreage of affected lands
<br />(Total surface acreage to be
<br />included im permit)
<br />13 Application fee (See applicable ~
<br />RULE to determine amount)
<br />~ 14. Present land use (t.e., agri-
<br />cultural, industrial, etc.)
<br />~f 13 '.. ,~It land use .
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