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pc cow <br />4~ ~~> <br />;:;~$ COLORADO DIVISION OF MINERALS AND GEOLOGY <br />,~e,s, 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 8~~~11/ED <br />S ---- --- -- ----------~ NOV 28 ?997 <br />APPLICATION FORM DIVISIGn of Miner, <br />RENEWAL OF A VALID, EXISTING PERMIT ~I~~Ueology <br />TO CONDUCT MINING IN COLORADO <br />This form is an application for successive renewal of a valid, existing permit to conduct surface or <br />underground mining and reclamation activities or other surface coal mining and reclamation <br />operations in Colorado pursuant to C.R.S. 34-33-101 , et seq. This application form is designed to <br />revise and update the application form currently included in your permit application. The right of <br />successive renewal applies only to lands and activity which were permitted during the previous <br />term. Extensions of the permit area and significant new activity within the permit area are subject <br />to the review procedures applicable to new permit applications, in accordance with Rule <br />2.08.5(1llcl and 2.08.4. Such changes will be handled by the Division as permit revisions, and will <br />be processed simultaneously with the application for renewal. Other changes to the permit will be <br />processed as technical revisions or minor revision in accordance with Rule 2.08.4. <br />For a renewal application to be deemed complete by the Division pursuant to C.R.S. 34-33-109171, <br />an applicant must submit: 111 all information as specified on this application form; 12) a copy of the <br />newspaper notice; (31 evidence that a liability insurance policy will be provided for the proposed <br />period of renewal; and 14) five reproducible copies of the permit renewal application with original <br />signatures. <br />For federal mines, a copy of the renewal application must be submitted to all agencies on the <br />federal agency mailing list at the same time the application is submitted to the Division, and proof <br />of distribution must be submitted to the Division. Copies of renewal pages modified during the <br />review process must be distributed in the same manner, along with proof of distribution. Proof of <br />distribution must be submitted prior to implementation of the renewal. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly the appropriate information as listed below. Supplemental sheets may be used <br />as necessary. Such sheets must be attached to the form and referenced or keyed to the numbers <br />on the form. <br />1. Permittee: ~U41~A/^-~nIJ~ /ri1~,~4/6!U(il (~~P© +(,f~Ti(9tJ <br />2. Name of Operation: 17~ ~o~ /u1dAi< <br />3. Permit Number (same as current permit number): C - $ 1 - O f 1 <br />4 <br />• 5 <br />Type of Revision: R N Renewal Number: 0~ <br />Application Submittal Date: ~~ / ~ 1 l Z <br />