PERMFILE126490

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

',~ N
STATE OF COLORADO
Mined Land Reclamation Board
Department of Natural Reaourcea
1}13 Sherman Street, Room 723
Denvet, CO 80203
TYPE OR PRINT CLEARLY
1. Name of operations /~e /q j~ ~) /P N N A~4' ~.I~C!
(Pit, mine, or site name) `
/
2. Name of applicant/operator (~ % .S .S LC/-2 O t'i^
(Name to be used on permit)

3.
Address and phone number of ~ ~
~ l a
- ~~YVCe. -
local offices Po 4~X Col(. C'ak ~-ct,Y ~~e r'vtl`7
4. Address and phone number Sc,w-a us a.6o,rc.
of general offices
S. Name and phone number of person ~ /ASS (~(/ -P~IjQ, y~
staff members should contact _ a ~~ ~
6. Parent Corporation, if any ,n o ~e~
(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
E
hib
P
2
l ass (~Ql~e.r
}
(If more than
,
ist in
x
it
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 b substance to be mined 1~~ .~
(Specify underground, strip, open pit,
d
bstanc
) to be mined)
t
(
'~ -
e
c. an
su
e
s
11. General location b elevation (Miles i ~,
6 direction from nearest town 6
r
imate site elevation) ~ ~ ,~
app
ox ~L' / D
_
12. County LC ~~
1}. Acreage of affected lands
(To [al surface acreage to be ~,
f
included in permit) '~~
14. Application fee (See Rule 2 to ,~o}~~~ ~ ~ +~/ Z,~.(,Jt,~
determine amount)
~/~
15. Present land use yy (~~
(i.e., agricultural, industrial etc.) ,/~ , ~ t9Y' E W~ ~
~'~ / n ~ ~~'v ~
!7
,V v PR nT_5 i.J2,a
16. Surrounding land uses ri n +D f '~

17. Proposed future land use -Ire„ I.c.r c..v,,,r~ ~
(Goal of reclamation)
1g. Other mining permits b operations ~ ~ / 5 ~ ;~/ Crf~' ie;
in Colorado (See Rule 2 for guidance)
19. The lands herein do not affect any of ~~,(h
the lands described in Section
1.56(9), (Specify affirmation)
-,. •.,.