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oF' COio <br />* COLORADO DIVISION OF MINERALS AND GEOLOGY <br />*X876 ' 1313 Sherman Sheet, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />NOTICE OF INTENT TO EXPLORE INVOLVING REMOVAL OF 'fir,, F1 ED <br />250 TONS OR LESS OF COAL r 2 A109 <br />PART I pw??,,,. •?Lamation, <br />Mining and Safety <br />Notice of Intent No. (Assigned by Division): _ Y-Z00 q - Z /Z. --o8 <br />Applicant: <br />LaC'. <br />Project Name: D2 y 2 K LZ?G? ?faNS /??S A ? roYa? 100 D d) ArI A <br />Date: rebrlbafV 2-01 Wc?q Commodity Mined or Explored: c®Q 1 <br />Mineral Ownership: Federal t? State _ Private ? <br />Surface Ownership: Federal ? State Private <br />Permittee <br />• Individual's Name: _ gym J ell <br />f t? <br />ob Z <br />t. 15 o <br />Company Name: 6a X17 f <br />u L L e G. <br />Address: ?D. ,ox Jay'/ . 5o1v-e1--cw--6 . Co 191ZIgil <br />Telephone: #4 9,29° qA <br /> <br />Permitting Contact (if different from <br />above) <br />Individual's Name: A? <br />A / <br />Ab I6 <br /> <br />Company Name: <br /> <br />Address: <br /> <br />Telephone: ( ) <br /> <br />Inspection Contact (if different from above) <br />Individual's Name: k Abd ?e- <br /> <br />Company Name: <br /> <br />Address: <br /> <br />Telephone: ( ) <br />• NOTE: Exploration. must be conducted in compliance with the Rules and Regulations of the Colorado Mined Land <br />Reclamation Board for Coal Mining, adopted in accordance with the Colorado Surface Coal Mining <br />Reclamation Act, C.R.S. 34-33-101 et SeMc . This form must be filled out entirely before it can be considered <br />complete. Two (2) copies of this Notice, including maps and additional attachments, should be submitted to the <br />Division of Minerals and Geology. Please refer to Rules 2.02, 3.05, 4.07, 4.21 and 5.01 for specific regulatory <br />requirements.