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• LIMITF III 'llllllll"IIIII lIT •PECLIL sss 1n�J o0 <br /> APPLICATION FORat <br /> State of Colorado - Application for Mining and <br /> Department of Natural Resources Reclamation Permit, pursuant <br /> %MTED LAND RECLW_ATION BOARD �� 2 , ���� to CRS 1973, 34-32-101, at seq <br /> 1313 Sherman Street, Room 423 \I <br /> Denver, CO 80203 (303) 839-3567 �-) I oL I 1 p 71- 7 <br /> The following explanations cover L1"`teiiap�att �o��ct�$o°ns (110's) and Special (Ten- <br /> Day Processing)(111's) applications. In the interests of efficient processing, please <br /> check the appropriate box to indicate which type of application you are applying for <br /> here. Ill permits may be issued only under special circumstances. Be sure you are <br /> eligible. <br /> LIMITED LMkCT OPERATIONS must disturb LESS THAN ten acres (including all <br /> roads, stockpile areas and any other surface facilities) over the life of <br /> the mine, and must extract LESS THAN 70,000 tons of mineral, overburden or <br /> combination thereof per calendar year. If the affected area is some fraction <br /> greater than nine acres, be sure NOT to round this figure out to ten acres in <br /> the narratives or elsewhere. <br /> aSPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN ten acres <br /> (including all roads, stockpile areas and any other surface facilities) , / <br /> and can ONLY be obtained where a federal, state, county, city, town or I. <br /> special district contract calls for work to be commenced within a SPECIFICALLY <br /> SHORT Tr E. <br /> i <br /> (Type or Prints Clearly) <br /> 1. Name of operation S <br /> (Pit, mire or site name) <br /> 2. Name of applicant/operator e , r a — <br /> (Name to be used on permit) <br /> 3. Address and Phone number of <br /> local offices _ <br /> I <br /> 4. Address and phone number of <br /> general offices <br /> 5. Name and phone number of person <br /> staff members should contact <br /> 6. Owner(s) of record of affected :and <br /> 12 1^ N <br /> (surface area)(lf more than 2, 1st below) N1, Alle-0 r <br /> 7., Owner(s) of substance to be mined M <br /> (If note than 2, list below) AM <br /> S. Source of legal right to enter ' <br /> (Indicate what type of proof is W ►^)1,9 — Q #-V e e <br /> included in EXHIBIT G - lease, <br /> deed, notarized letter, etc.) w p N C C <br /> 9. Type of mine & substance to be <br /> mined (Specify underground, strip, <br /> open pit, etc. & substance(s) to <br /> be mined) Sp�,s J aim" <br /> ti <br /> 10. General location & elevation <br /> (tiles & direction from nearest ' <br /> town & approximate site elevation) <br /> 11. Connty <br /> 12. Acreage of affected lands <br /> (Total surface acreage to be <br /> included in permit) .., ' <br /> 13. Application fee (See applicable <br /> RGLE to determine amount) <br /> 14. Present land use (i.e. , agri 00 MY iV <br /> cultural, industrial, etc.) <br /> '_5. Pteoosed future land use N'tl � <br /> (Goal of reclamation) I � <br /> (over) <br />