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• ~ <br />II I I I I I I I I I I I III I A- ~~, / <br />II ~) ~ v n, f o C o~oy pE ~ . <br />- <br />y <br />s99 ~ ~ 1 ~k~ /s7~ <br /> ~ <br /> LIMITED IMPACT AND SPECIAL (TEN-DAY) .~ 7S ~ <br /> PERMIT APPLICATIOI7 FORM <br /> <br /> STATE OF COLORADO R EC EIV E D Application for Paining <br /> Pfined Land Reclamation Board and Reclamation Permit, <br /> Department of Natural Resources Pursuant to C.R.S. 1973, <br /> 1313 Sherman Street, Room 723 JUL 2 1 1980 <br />~ 34-32-101, et seq. <br /> Denver, Colorado 80203 - <br /> AAINED LAND RECLA(NAtIU~J <br /> LI24ITED L`fPACT OPERATIQj~p•~. ~~y~ gT~~g~dAN ten acres (including all <br /> roads, stockpile areas and any other surface faci lities) over the life of <br />the mine, and must extract LESS THAN 70,000 tons of mineral, overburden <br />or combination thereof per calendar year. If the affected area is some <br />fraction greater than nine acres, be sure NOT to round it up to ten acres <br />in the narratives or elsewhere. <br />SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN ten <br />acres (including all roads, stockpile areas and any other surface <br />facilities), anr' can ONLY be obtained where a federal, state, county, <br />city, town, or special district contract calls for work to be <br />commenced within a SPECIFICALLY SHORT TIME. <br />'TYPE OR PRINT CLEARLY Y"I~G_ <br />1. Name of operations ~ ~ /I/ ~ Q ~ /~ ~/~ <br /> (Pit, mine, or site name) <br /> <br />2. <br />Name of applicant/operator n / ~J' <br />C' ~ ~ g,Pgy<~ P~od~~~s L/VG. <br /> I <br />(Name to be used on permit) <br /> <br />3. <br />Address and phone number of I G /~, <br />'f- ~/1`AGio, C/~o <br />~ /'7~ G~ ',S^Q7 <br /> local offices / <br />~~~3 ., nfn~~ _Z~Y~~ <br />4. Address and phone number ~j~ ~y~ .G <br /> of general offices <br />5. Name and phone number of person ~~ .9 <br /> staff members should contact _ 2 ~ <br />6. Owner(s) of record of affected ~ ~ ~'~~ l~i~ V ~ o~i 7~o~t~_ <br /> land (surface area) <br /> (If more than 2, list below) <br />7. Owner(s) of substance to be mined <br /> (If more than 2, list below) <br />8. Source of legal right to enter <br /> (Indicate what type of proof is <br />included is Exhibit G - lease, deed, ~/ <br />~ ~ a ~.= .N ~' iG'~c /vl ~w <br /> notarized letter, etc.) <br />9 e of mine 6 substance to be mined <br />T <br />. yp <br />(Specify underground, strip, open pit, ~p ~ y~ ~ Q/~ P_~v /~' <br /> etc. and substance(s) to be mined) <br /> <br />0 <br />tion 5 el <br />ation (`files <br />G <br />r <br />l l / / n <br />r ~o °Y ~A "1' ° I/ n <br />. <br />. ene <br />oca <br />ev <br />a <br />6 direction from nearest town S Co% ~~jD~,Oy~ G;~'Od ~~, <br /> approximate site elevation) <br />.1• County ~ p. ~~tj.'{~, <br />.2. Acreage of affected lands ///J <br />/7GiG'PS ~~ ~2c r <br /> (Total surface acreage to be <br />included in permit) <br />3. Application fee (See applicable Rule <br /> to determine amount) <br />w <br />