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LIMITED IMPACT (110) and <br />~CLAI. TEN-DAY (111)~PERMIT • <br />APPLICATION FORM <br />State of Colorado ~~,~°r:.~~~~'~t~~ <br />Department of Natural Resources ' <br />MINED LAND RECLAMATION BOARD <br />1313 Sherman Street, Room 723 ~ ~~~ " J 1y81 <br />Denver, CO 80203 (303) 839-3567 <br /> <br />The following explanations cove~s~iYm~6d^}I9dpa¢tl ~p~:_gestions (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. 111 permits may be issued only under special circumstances. Be sure you are <br />eligible. <br />L"J LII4ITED It~ACT OPERATIONS must disturb LESS THAN ten acres (including all <br />u 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 />D SPECIAL (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 <br />special district contract calls for work to be commenced within a SPECIFICALLY <br />SHORT TIME. <br />(Type or Print Clearly) <br />1. Name of operation GRADER PIT <br /> (Pit, mine or site name) <br />2. Name of applicant/operator <br /> (Name to be used on permit) <br />3. Address and phone number of <br /> local offices 81301 <br />4. Address and phone number of 28481 U.S. fiIGH[^IAY 160, DURAt1C':O, ~. <br /> general offices 81301 <br />S. Name and phone number of person A7BERT PAYCHECK 303 533-7545 <br /> staff members should contact <br />6, Owner(s) of record of affected ]and gll,L C & 7EAN <br /> (surface azeaxIfmorethan2, list below) <br />7. Owner(s) of substance to be mined , <br /> (If more than 2, list below) <br />8. Source of legal right to enter <br />(Indicate what type of proof is DEED <br /> included in EXHIBIT G - lease, <br />deed, notarized letter, etc.) <br />9. Type of mine b substance to be <br />.mined (Specify underground, strip, Opp PIT - GRAVEL, <br /> open pit, etc. b substance(s) to <br />be mined) <br />10. General location S elevation <br />(Mil <br />& di <br />ti <br />t <br />f <br />APP20X. 5 P4TT.FS SOUTH OF DURAYd('~O COLO. <br /> rec <br />on <br />rom neares <br />es <br />town S approximate site elevation) ELEVATION = 6750 <br />11. County ~ P~,A <br />12. Acreage of affected lands <br />(Total surface acreage to be <br />included in permit) <br /> <br />9.99 ACRES <br />13. Application fee (See applicable <br />RULE to determine amount) <br />$125.00 <br />14. Present land use (i.e., agri- <br /> cultural, industrial, etc.) <br />15. Proposed future land use <br /> (Goal of reclamation) <br />III IIIIIIIIIIIIIIII` <br />sss <br />Application for Mining and <br />Reclamation Permit, pursuant <br />to CRS 1973, 34-32-101, et seq <br />~ (over) <br />