PERMFILE118027

• Permit No: M1981108
• IBM Index Class Name: Permit File
• Doc Date: 5/20/1981
• Doc Name: LIMITED IMPACT 110 & SPECIAL 10-DAY 111 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

Li2IT'°III III III III III I
SP°-CT_~I. I'R_`I-DAY (111) PEPKIT
?~v •*_CdT?OY•'?OR~:.~ s=ue
State ci Colorado
Department of `iatural Resources ,
NS1~ LAND REC•.A.`L~TION HOARD inl~Y ;~ ~,, i'.~i;~
1313 Sherman SCreet, Room 423
Deaver, CO 80203 [phone] 'v;ii`:=-i ~ ~~• ~ ~ ~~ '~~i"d
. ~~3~
n ~j ~ O ~
(~/IIYf_~[~~1 ~ ` ~
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Application for `lining aad
Reclamation Permit, pursuanC
to CRS 1973, 3~-32-101, et sec;

.._:,, .....,~ ,. _~_:~nrces
She following eaplaaacions cover Limited Imoacc applications (110's) aad Special (Ten-
Day Processiag)(111's) applications. Ia the +sterests of efficient processing, please
check the appropriate boa to indicate rrhict~ twe of application you are applying far
here. I11 peraies may be issued only order special circumstances. Be sure you are
eligible.
L1:lIT~ l~ACT OPERATIONS must disturb LESS THAN ten acres (iacludiag all
roads, stockpile areas aad nay other surface facilities) over the life of
the mice, aad must eztract LESS THAPI 70,000 tons. of mineral, overburden or .
combiaatian thereof per calendar year. If the affected area is some fraction
greater than nine acres, he sure NOT to round this figure out to ten acres is
the narratives or elsewhere.
SPEC72I. (TE2I-DAY PROCESST`Ii G) operations must disturb LESS THA2i tea acres
(including all roads, stockpile areas aad nay ocher surface facilities),
aad can ONLY be obtained whern a federal, state, county, city, tow or
special district contract calls for work to be commenced within a SPECIFICALLY
SHORT TTY.
(Type or Print Clearly)
I. Name of operation Pablo Vas uez Stone Co
(Pit, mina or site name)
2. :lame of applicant/operator V na
fName to be used on permit)
3. ?ddress and phone number of
Iocal offices 823-6888
4. address aad phone number of
~eaeral offices
5. name aad phone number of person Pablo Vasquez, 823-6888
staff members should contact Dave Hobbs. 82~-51102
6, Ocmer(j) of record of affected 'and I Golda Ohline
(surface area}(If mors thaa2, list below) I
i. Owner(s) of substance to be aiaed
(If more chaa 2, list below)
8. Source of legal right to eater
(Indicate ghat type of proof is
Verbal cement
Secluded is E~IBTT G - lease,
deed, notarized letter, ate.)
9. Type of mine a substance to be
mined (Specify uadergrouad, strip,
open pit, etc. b substance(s) to
be mtaed)
10. General location S elevation
s S di
frva n
()Lil
ti
t
5mi 1P of L ons Colo• Elev. 6 00
e
on
eares
rec
cow 6 approxi.~aate site elevation)
I i. County Lorimer
I2. Acreage of affected Iaads
(Total surface acreage eo be
'_acluded is persi.t)

1~,0 acres
I3. Application fen (See applicable
RLZE to determine amount)
~
I.;. Present Iand use (i.e., Agri- Mininn Grazin
cultural, industrial, etc.)
.5. Pro?used t'utare Iand use ~ F_ orpstlGrazine
(Goal df recIamacicn)
-- ~
(over)