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7778 SPECIALETENMDAYT(111~)PERMIT ~ '~I'I"~"I"""II <br />APPLICATION FORM s <br />J a ~!«.. i '~ 'x~~ Y.w <br />State of Colorado Application for Mining and <br />Department of Natural Resources Reclamation Permit, pursuant <br />MINED LAND RECLAMATION BOARD 1'~+R ) _', ~~~1 to CRS 1973, 3-32-101, et seq <br />1313 Sherman Street, Room 723 <br />Denver, CO 80203 (303) 839-3567 NIVNEL` L~.tvJ F.+GLAN~AIION <br />.. .... ~. ~. ..ri'J -... rJ <br />The following explanations cover Limited Impact applications (llOs) and Special (Ten- <br />Day Processing)(Ills) applications. In the interests of efficient processing, please <br />check the appropriate box to indicate which type of application you are applying for here. <br />XX 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 />I~ SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN ren 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 />SPECIFICALL'( SHORT TIME. <br />(Type or Print Clearly) <br />I. Name of operation ~~ td~ <br /> i <br />( <br /> Pit, m <br />ne or site name) <br />2. Name of applicantloperator <br /> <br /> (Name to be used on permit) <br />3• Address and phone number of C 8-625 <br /> local offices <br /> g,7/rby ~} <br />4. Address and phone number' of p,0. Box 181, Craig, Colorado 81625 <br /> general offices <br /> 82k-6467 <br />5• Name and phone number of person r• 8'34-64$7 <br /> staff members should r-ontact <br />6. Owner(s) of record of affected <br /> land (surface area) (If more United States Government- Bureau of Land Management <br /> than 2, list below) <br />7. Cwner(s) of substance to be mined nit went- Bureau of Land Mana ement <br /> (If more than 2, list below) <br />8. Source of legal right to enter <br /> (Indicate what type of proof is <br /> included in EXHIBIT G - lease, <br /> deed, notarized letter, etc.) <br />9• Type of mine i; substance to be <br /> mined (Specify underground, strip, 0 en it eeions e~etals silver, old, copper, c <br /> open pi[, etc. & substance(s) to <br /> be mined) <br />10. General location & elevation <br /> (Miles b direction from nearest oximatel 27 miles northwest of Craig, Colorado <br /> town b approximate site eleva- <br /> tion) lion <br />II. County <br />ifof~i <br />12. Acreage of affected lands Less than 10 acres, approximatelp 9.9 <br /> (Total surface acreage to he <br /> included in oermit <br />13. Application fee (See applicable <br />` <br /> RULE to determine amount) i ~ ~ : ~ ;~ <br />+ <br />$"~•~ /~~ '' ~ <br /> , <br />(overj <br />tc <br /> <br />