PERMFILE127160

• Permit No: M1983050
• IBM Index Class Name: Permit File
• Doc Date: 3/28/1983
• Doc Name: LIMITED IMPACT 110 & SPECIAL 10-DAY 111 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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MIT.:\`:U t:ILDLIFE QUESI'70XA'IRE •
for limited impact and select regular mine applications
1. Name of Company/Pfine; DOH - State Land - Jensen Pi
2. Name/Address/Phone of Contact Person: Joe Intermill, Box 850, Greeley,
Colorado 80632 - Phone [phone]
3. Location of Mine: SW'-i, Sec 16, T9N, R44W, Sedgwick Count
(County, Township, Range, Section to nearest quarter quarter; Exhibit A-`ILR appl.)
4. Nearest Town/General Location: 13 miles N of Holyoke
5. Land Ownership (Circle) 1. Private 2. BLM 3. USFS 4. Other State Land Board
6. Present Land Use: Drv Land Farmine
7. Proposed Final Land Use: Same
8. Type of Operation: 1. Surface 2. Underground
9. Minerals being mined: Sand and Rravel ___`
10
11. Piffles of roads to be constructed:
12. Life of Pfine (years): Indefinate
13. Description of Operation and Reclamation -- Additional sheets may be attached
(Exhibits B b E-PEER)
Number and Description of Surface Acres Disturbed by Mining/not including roads
(Exhibit D-PIER) : 15 acres
Very shallow topsoil will be stripped and stockpiled. Mining will be accomplished
with a front end loader. At conclusion of minin¢, the area will be graded to
contour, topsoil replaced and reseeded to local SCS specs to ~at~.yQ_.Qrasaes.
14. Please enclose ;taps o~ Project Operation, Disturbance Areas and Recla~~ation (Exhibit
C.) This will expe to process 'n g. Your cooperation is app~7rec~iated. z
15, Prepared by: ~~ ,~ / Date: =Y ~'/~-L
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