PERMFILE128639

• Permit No: M2004008
• IBM Index Class Name: Permit File
• Doc Date: 1/30/2004
• Doc Name: First Submittal of the Application
• From: Joseph Curtis Harden
• To: DMG
• Media Type: D
• Archive: No

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DIVISION OF MINERALS AND GEOLOGY Rtl,tl V C V
Depanmeni of Natural Resources /
'- _ Sherman 8t., Room 275 ~
~enver, Colorado 80203 ~ 1,
- IAN 2 ~ Z~Q'1 /
J `
Phone: [phone]
FAX: [phone]
pivision ~f Minerals and Geolo~Y
OF COLOI~DO
/~;~s~ ~ubntit-~rQ
LIl~IITED ]IMPACT OPERATION (ll0(2)) r/
RECLAMATION PERMiT
APPLICATION FORM
CHECK ONE: ~ New Application (itnle 1.4) /~[~$ Cpnversion Application (Rule 1.11)
Permit # M-~- (provide for conversions of existing permits)
DIVISION h
MINERAI
&--
GEOLOG
RECLAMATIO
MINING•SAFE1
Bill Owens
Governor
Greg E. Walther
Executive Director
Michael B. Long
Division Director
The application far a Limited Impact Designated Mining Operation Reclamation Permit contains three major parts: .(1) the
application form; (2) Exhibits A-J, any required sections of Pxhrbit S and Geotechnical Stability Exhbit, as required lry the Office,
and outlined in Roles 6.1, 6.2, 6.3, 6.4.19 and 6.5; and (3) the application fee. When you submit your application, be sure to include
oye.(1)~ed and notarized oaginal and one (1) copy of the application fob, two (2) oopres - ~ sadrons of
6.4.19 Fxhrbit S and 6.5 (Geotechmcai Stablity F..xhrbit), as regtired, and a check for the appflcatro~descnbed ender (4) below
Exbrbits should not be Uormd or is a 3-ring binder, maps should be folded to 8 1/2" X 11" or 8 I/2" X 14" size. To expedite
processing, Please provide the i~'ormation in the format and order desen'bed in this form.
GENERAL OPERATION
Type or print clearly, m the space provided, all information descn'bed below
rT•JRPN • ~~7rJ l~//4RAR/V ~
I. Apnlicant/operator or comnarnname [name to be need on the permit): ?_ H k n~ e r n, ~ n r x. nn r.~. i M a ccr rA~
1.I T9Pe of organization (corporation, partnership etc.): PSI (y A ; R n.r In, r K, o Aa /e a 7o n n h n o anrr
12 LRS. Tax ID No.:
2. Operation name (pit. mine or site name): T u rt n.r o u iv r n i n, ~., i ,y ) M 4 t 4 ~Y / ~.,
3. Permitted acreaee (new or eristin¢ site):
4. Fees:
L R 3 r 'Tra pn.~ -rtn.c ~ c~ permitted acres
4.1 New Application
4.2 Conversion Fee (from 110d W 110(2), (Rule 1.112(2))
5. Pronarv eommoditie(s) to be mined: G O L a
875.00 application fee
N~A 5875.00 conversion fee
6. Name of owner to the sprface of affected land: J 6 5 R PN_ e v n T r s I-1 A R 27 R N
7. Name of owner to flu: subsurface riehts of aflecfed land: J O S E IoN c V K T l s I"I A R rN d N
8. lope of minim operation: ~ Suiface Underground In-situ