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,~ <br />r. ~~. <br />-:i.----- Cc^'qct Cca_' ~"ir.inc in Colorado ~., <br />' _ .. .+., ~~ ~r T. <br />9-ate of Colarado ,__ _-~'~~"%+p_1'cat~~~B~snr. ce <br />De; art~nent of~ Natural; Rescurces or undercr na a'~. g <br />r!i::ED LAND REt`L:+::i+TION~ DIVZSiON' a :+311~!~-~IP~D~OM_ Coal <br />.; 1313 5}:erman Street, Room 923 - _ ~ ~{g„®i~Q~P _ _ ions <br />L~nver, rolosad0 80203 (303)839-3567- ~~ ~ i ~ Colorado~c~~~~rifX =hC~ 1973, <br />( ~ ~_~ ~.~39 33-101, et:.s Vic. <br />For an application to 'be aeen.~d comoIete by.:the Division.;pursvant to CFS ?•973, <br />39-33-Z 03 (S)and Rvle.1_04 (3.0),.~~.an 'app'licant must:~~ (1) supply~~~~a11 information as <br />soecif'ed on this application form; (2) submit five..reprodvcible copies of tre pernit <br />application wiEh original signatures;. and•(3)..pay.the appropriate fee recuired''by <br />Rule 2.01.6. <br />Please note that this fG;m is only.a:listin¢ of general category reoui~ements and <br />does not consti'tpte. a checklist df detailed+-permit application recvire.:.ents. A <br />finding of completeness.shovId not .be interpreted..,to imply•adea;acy of an appli- <br />cat_'on. Addtibnal information not+'2'isted 'ohs-this for..i:nay=be repaired for adeovacy .. <br />r.. <br />depending upon~~t]ie individual circumstances'of~a~~apolication. <br />t.. ..,....:, .. <br />y <br />This form 'consist's of two major parts: (1) .a; section entitled. Gen eral Oceration . <br />Information and f¢) a sgction entitled application 72eouirer„ents. specific instruc- <br />tions~for filling in thc~~'Aecessary~informationfor each ~section`appear5~i.:c~ediately <br />below the title~~bf each~~Section. ~ ~+°~. <br />(:. GENERAL .OPFR fiTZON. INFOR.MATSI7N~ <br />`Type'or print c3 early t1r~ a.ptiropriate;infor;~ation as listed below. Supplemental <br />s`.eets may be used as. nei~essary~ such` sh~st's~ mvst~~be attached t'o the _`orm and re- <br />erenced or keoed;.to th~~numbers.on the~form.~ <br /> + - <br />1. Name of Operation H-G Coal Company <br /> (Pit, mine'or'site name) -.Hayden'~u1ch Mine . <br />2. /va.ae of Aopli$ant H-G' Coal Company <br /> (lY~me to be~iused on•pezmit -. .. .~ <br /> ~• <br />lie permittEe) - <br />I . <br />. <br />. <br /> <br />?a. ' <br />z ~ <br />address andlp~bne nurr+ber of <br />P.0.'S~ox 771 <br /> local offices' ~ Hayden; Colorado 81639 '303=276-3I16 <br />2b. Address and ,phone number of 3333 Quebec St. ,, <br /> oeneral offices. ~ <br />~ Su1.te~8800 ~ ~'~ <br /> ' Denver, Colorado. 80207 303-339-0779 .' <br />3. ;Jame and.phbne number of person. Cass Legal <br /> staff members should+contact 303-339-0779. ' <br />A. Parent Corp3ration, i° any ~ I WR Grace <br /> (Include pang grid address) I 3400 First International Bldg. <br /> rto' I Dallas, Texas •75270.- <br /> <br />