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s <br />F <br />r <br />•oom 715, 1845 Sherman St. <br />Denver, Colorado 80_'03 <br />1. tlane of operator <br />Operator's Pisa of Reclana,_en <br /> <br /> <br />III ~II~II~II~~II III <br />sss <br />LAS:D a:.c* _~a~_,.:; so.~~ <br />Deoartnent of ::atural tes.~;rces <br />.. r_. , ,~. M~~i'.. CH _... .... <br />~.~~:y'=!VED <br />CGi ., ~~tii5i0iV Oh „,h~f5 <br />Telephone: 892-3401 <br />Phone X95 6857 <br />2. Addr=_ss of operator G5,- •• G5•~ ••c~-e. :c--r.-cc "'•• .:c~c~aoo E"^22 <br />3. Legal description of af:ected _aad _c" - 1=, -- 'p I c~'h, cr.Gc ;;; •, <br />kda-s County, Co!craco <br />4. (a) :lumber of acres <br />!!4 zcres <br />(b) _r.itial permit nu:aber <br />5. Describe herein the operator's choice of rec.anat:on i^ accordance crith the provisions <br />of 92-13-6, CRS 1963, as amended. Details of th_s ?.an sha'_1 be anorooriate to the <br />type of reclamation designated. <br />• <br />6. <br />i <br />i <br />i <br />r <br />J <br />Enclose herewith an accurate nap of the affected area. The nap shall shoo: <br />(a) All pertinent detai'_s such as reads and access to the area and reclamation accon- <br />plished <br />(b) Section, township, range a^d cc~~nt~: lanes •.__.._.. _:.e sco?e pf the na?; <br />(c) Access to the area from the nearest p.:~:ic road; <br />(d} A meridian; <br />(e) A title containing the nac+e of the operator and his address; <br />(f) Scale of the map; <br />(g) Vame of engineer or other person caho ?repared nap; <br />(h) The date; <br />(i) The township, range and county of tie affected area. <br />7. I hereby certify that the fore;oir.g and at=ached ir`c ratio^. is complete and correct <br />as detenained _`ron all availab_e :eccrds. <br />LASD RECLAaATIO:~ BOARD <br />i • Approved by <br />Title <br />Date <br />Conditions of approval, if ar.7: <br />~.- <br />._t}e a cr~`ar~ <br />r /, <br />~, , ~.i_5 <br />1 <br />