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~ ~~~' ~~~ <br />~~oFo~ SEP 2 51885 <br />9 <br />ye o` DEPARTMENT OF NATURAL RESOURCES RECUMATICp~j p,C <br />„ ~~ u,o T r Davitl H. Getchea E.e<utive D~rectw ~sION <br />'e.'! MINED LAND RECLAMATION DIVISION ; <br />DAVID C. SHELTON, Director <br />i <br />Richartl D. Lamm <br />Governor <br />REGULAR (112) PERMIT <br />APPLICATION FORM <br />~~,~.~s bc~~~s~~ ~ ~a ~~ <br />Ppplication for t4ining and Reclamation Permit, Pursuant to C.R:S. 1973, 34-32-101, <br />et sea, as amended. n +"'1940 - ~S~O•~ <br />_- m-~o-()o Am UlCXV .~ ~-s'^4?oho-Ito-c9c~ <br />(Type of Print Clearly) <br /> Colorado Sand & Gravel Quarry <br />1. Name of Operation <br />(pit, mine or site name) <br />2. Name of Applicant/Operator Colorado Sand & Gravel <br /> (name to be used on permit) I c/o Bob Siegrist <br />3. Address and Phone Number of 6999 York St „ Denver, CO 80229 <br /> Local Office I 289-6441 <br />4. Address and Phone Number of same as above <br /> General Office <br />5. Name dnd Phone Number of Person gib Fleming. 426-8438 or <br /> Staff Members Should Contact I gob Siegrist, 285-6441 <br />6. Parent Corporation, If Any „~nP <br /> (include name and address) ~ <br />I <br />1. Owner(s) of Record of Affected Colrado Sand & Gravel, a General Partne <br /> Land (surface area) I Henderson Development, a General Partne <br /> (if more than two, list in <br /> EXHIBIT P) <br />8. Owner(s) of Substance to be same as above <br /> Mined (if more than two, list <br /> in EXHIBIT P) <br />rsh <br />rsh <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866-3567 <br />Page 2 <br />