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<br /> Li:~IT~ L`L°aCT <br />SPECL~h TEi]-Da°. (110) <br />(111) and <br />?E2`!IT <br /> a.°PLICd:i0:1 ~OQ~S <br /> <br />State o? Colorado <br />Departaent of Satural Resources <br />,"?` r» LAND RECI.a~~i~1TI0N 90ARD <br />1313 Sherman Street, Room 423 <br />Deaver, CO 80203 (303) 8~1-3567 <br />iii iiiiiiiiiiiuiii <br />999 <br />application for :4iniag and <br />Reclamation Perai.c, pursuant <br />to CZS 1973, 34-32-101, et seq <br />The following explanations cover Liaited Lmnact applications (110's) and Soecial (Tea- <br />Day Processing)(111's) applications. In the interests of efficient processing, please <br />check the appropriate bas to indicate which type of application you are applying for <br />here. II1 pernits may be issued only under special circumstances. 3e sure you are <br />eligible. <br />LL`fIT~ L~fD?.CT OPE~aTIONS lust disturb Lc55 THA.`I tea acres (including all <br />roads, stoc:cpile areas and nay other surface facilieies) over the life of <br />the mine, and Est extract L-aS5 THA21 70,000 tons of mineral, overburden or <br />cccb+=aticn the~ef war calydar near. if the affected area is some Fraction <br />greater than nine acres, be sure NOT ea round this figure cut to can acres is <br />the narratives or elsewhere. <br />S?°-CL~L (T°.:.`I-DAY YROCESSIVG) operations must disturb Lc.SS Tv..dv ten acres <br />(including all roads, staclcpile areas and nay ocher surface facilities), <br />and can ONLY ba obtained vhera a federal, state, county, city, town or <br />special district contract calls for var'.c to be commenced within a SPECLTICALLY <br />SHORT TLlE. <br />(Typa or Print Clearly) <br />i. Nmme of operation <br /> (tit, nine or site name) <br />2. Vmme of aoolicaat/overator / • <br />~ <br /> (Vane to be used on permit) ~ L ~ ~, ~ <br />~G.r r Y <br />3. address and ohane number of ~ o , f' <br /> Local of°ices o _ ~.~. ~• <br /> <br />S. <br />address and phone number of <br />,5 co nn <br />~ 6 tG~ ~~~vvw»1.~~r~*, La- nn <br />~o . ~0 4S <br /> general of `ices ~ 0 3 71 y- .~2 2 ~ <br />3. Vmme and phone number of person I /~, ~. J, ~ r d /__ ~'~c r r v <br /> staff members_hould contact ~ ,j o z ~1 Y - _~_:~ r? r~~.c:> - 303 ~ 7:l4-,3791 <br />6, '~-er(s) of reeor3 of affected sad <br /> (sur?acs arcs X I-' acre C-ran 3, 1'st below) <br /> <br />7. <br />Octier(s) of substance to be mined i 0 <br /> (If mare than 2, list below) <br />3. Source of legal right to enter <br />(L-.dicate what type of proof is <br />/, %;• ~i t ~ <br />~ ~ L <br /> included is ~IDTT G - lease, <br />deed, notarized letter, etc.) ~' <br />9. Tvne of nine a substaIICa to ba <br />mined (Speci_v underground, strip, <br />, <br /> open pit, att. b substance(s) to <br />be ai.aed) <br />I0. C~nera' acst_on ~ clews*_ion <br />& di <br />t <br />Jul <br />i <br />~ <br />7 6 3 <br /> rect <br />on <br />rop nearest <br />( <br />es <br />towns approx'~ta site elevation) ~ ~ <br /> <br />I2. acreage of affected Iaads <br />(Tote! sur'_ace acreage co be <br />~c'_uded is per_.i.t) I <br /> <br />7. <br /> <br />~ 3 Q.("^ oc~ <br />13. aDDllCatiJA tae (J'2°_ applicable <br />3L.?. co determine amount) , ~/D,S, 0 0 <br />I~. _resent land use (i.e., agri- I LL i t r <br />c,itcral, industrial, etc.) j <br />I]. ?rC*]OS2d '1L•Sre Lana LLS2 i l( t <br />(C~7a1 Cf reCl a'-l'aLi Cil) ~ <br />(J /erJ <br />8av 59 <br />.y <br />Kvw. <br />Y-_ r <br />._ ~... ~._ - ~ _ .Y <br />