PERMFILE126490

• Permit No: M1986040
• IBM Index Class Name: Permit File
• Doc Name: REGULAR 112 PERMIT APPLICAITON FORM
• Media Type: D
• Archive: No

4 ____. • ~ IIIIIIIIIIIIIIIIIII
] ,. REGULAR (112) PERMIT APPLICATION FORM eas
STATE OF COLORADO Application for Mining and
Mined Land Reclamation Board Reclamation Permit, Pursuant
Department of Natural Resources to C.R.S. 1973, 34-32-101 et seq.
1313 Sherman Street, Room 723
Denver, CO 80203 C_
TYPE OR PRINT CLEARLY ~~ ~ `~ /~
1. Name of operations _~,~ /q j~ /'C" j 1/ Py~ (Sfj ,(~ q~ ~,(~(1
(Pit, mine, or site name)
2. Name of applicant/operator ~ ~l S ~ ~,~~jQ ~.,
(Name to be used on permit)
3. Address and phone number of ~ ~ d - 1~7~~-L -
local offices
4. Address and phone number
of general offices

S.
Name and phone number of person //J
~/-'jSS W-?iD2Y~
staff members should contact - a ~~ ~
6. Parent Corporation, if any
(Include name 6 address)
7. Owner(s) of record of affected
land (surface area)
(If more than 2, list in Exhibit P}
8. Owner(s) of substance to be mined
(If more than 2, list in Exhibit P)
9. Source of legal right to enter
(Indicate what type of proof is
included in Exhibit 0 - lease, deed, /~
D ~-
notarized letter, etc.)
10. Type of mine 6 substance to be mined ~ ~7~ (-
(Specify underground, strip, open pit,
i
ed)
d
(
) t
b
b i
~'
e m
n
etc. an
stance
s
o
su
11. General location b elevation (Miles ~,
b direction from nearest town S
ite elevation)
i
at ~ ~ ,~
m
e s
approx ~e i o-
12. County u T~
13. Acreage of affected lands
(Total surface acreage to be
,
included in permit)
14. Application fee (See Rule 2 to
determine amount)
15. Present land use
(i.e. , agricultural, industrial, etc. )
_ t~.~-
~ ~ u ~'~Q'^'' ' ~~ ~,~~
V ~,J
16. _
Surrounding land uses hi ~ n "~a ~

17. Proposed future land use
(Goal of reclamation)
18. Other minin ermits 6 o erations
g P P ~
2. ~ i 5 / .c/ Zr/3 iA
in Colorado (See Rule 2 for guidance)
19. The lands herein do not affect any of
the lands described in Section
1.56(9), (Specify affirmation)