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• LLfITED I:•S?ACT <br />SPECIAI. TEiI-DAY (110) <br />(lil) a-d <br />?B.`".I <br /> <br /> <br />State of Colorado Application for :".iniag and <br />Departeat of :iatnral Resources Reclamation ?emit, pursuant <br />=~ LL`1D RSCLA2"_1TION 90ac2D to CZS 1973, 34-32-101, ec seq <br />1313 Sherman Street, Room 423 <br />Deaver, CO 80203 (303) 80G-3567 <br />T'ae following ezplaaations cover Limited Impact applications (li0's) and Special (Ten- <br />Day Processing)(I11's) applications. Ln the interests of efficient processing, please <br />checti the appropriate boa to indicate which t;rpe of application you are applying for <br />hero. 111 pewits ray be issued only under special circimstances. Be sure ;rou are <br />eligible. <br />LL`fI:=D L`SPACT OP~ITIO:IS gust disturb LcSS T3eL`I tea acres (L^.cludiag all <br />roads, stockpile areas and nay other surface facilities) over the life of <br />the mine, and must eztract LESS T3AV 70,000 tons of mineral, overburden or <br />c^~iration thereof per ca:.eadar year. ii the 3=fatted area is same fract~oa <br />;neater than nine acres, be sure VOT to round this figure cut to *_ea acres <br />the narratives or alsawhere. 'iI() <br />SP°ECZ>.L (TE.`I-DAY P30CESSL`IG) operations must disturb LZSS T°s12i tea acres/ ,l/Y~'`~ <br />(including all roads, stockpile areas and nay other surface facilities} YY„ff__// <br />wad can ONLY be obtained where a federal, state, county, city, cow or <br />spec±al district contract calls Eor work to be commenced within a SPECrciC2LLY <br />SHORT TL~SE. <br />(Type or Print Clearly) <br />? . vane of oneraeion I GRAPiD GRAVEL <br /> (Pit, mine or site Wane) <br />_. Vane o' applicant/oneraLOr F2 T!' P (`I <br /> (Vase to be used on perait) <br />3. Address wad phone number of I °500 ; Fth St, r".remmlin~, Colorado s,ntl~^ <br /> local of=ices 3D3-'?24-322; <br />_. Address wad phone number of 500 5 nth St. KremmlinF. Colorado ROFa59 <br /> general offices ~ Kre~nmling, 3~3-724-3228 <br />:. flame and ?hone number of person I Richard r:.. Currv <br /> staff aembers should contact 303-724-3228 office, home 3o3-;z~~-3792 <br />6, ~ :-:or(s) of record of affectedand ~ 0 Fa ~i' 1" <br /> (Stir_3C°- area ;( Lr raL'e L`.dll 2, list below) <br />'. Oarer(s) of substance to be mined ; ~;• <br /> 1, if more than 2, list belcw) <br />3. Source of legal right to enter <br />(indicate ;hat type of proof is <br />T~otorized letter from owner <br /> included is ~III'T G - lease, <br />deed, notar{sed letter, etc.) <br />?. T•rte of mine 6 substance to be <br />Wined (Spec:? underground, strip, <br />(~Aen Pit Gravel <br /> oven pit, ace. S substance(s) to <br />be rued) <br />l0. ;eneral location S elevation <br />(`Sil <br />S di <br />= <br />i <br /> as <br />rect <br />on <br />row nearest <br />tow S approximate site elevation) <br /> <br />3 N'". F of Kremmlin¢- Ele~~ation is ?3F3 <br />Ii. County <br />nrand <br />1'. Acreage of affected lands <br />(Tot. sur'_ace acreage to be <br />included is per-fit) 7 <br />. R, ACrees <br />l3. Application foe (See applicable <br />Rti~ co deterai:.e amount} <br />';15.00 <br />_ ?resent Land use (i. a., agr~ ( Aericulture erazine <br />_S1Car31, iadaSt +di, etc.) <br />i <br />_.. ?reposed future land use I A~*ri rnl+nra ~'razinu <br />(Coal of reclamaticn) j <br />i..ar) <br /> <br /> <br />