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oe • cow <br />H V <br />COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /># 1876 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />APPLICATION FORM <br />RENEWAL OF A VALID, EXISTING PERMIT <br />TO CONDUCT MINING IN COLORADO"`'' <br />This form is an application for successive renewal of a valid, existing permit to conduct surface or <br />underground mining and reclamation activities or other. surface coal mining and reclamation <br />operations in Colorado pursuant to C.R.S. 34-33-1 01, et .req. This application form is designed to <br />revise and update the application form currently included in your permit application. The right of <br />successive renewal applies only to lands and activity which were permitted during the previous term. <br />Extensions of the permit area and significant new activity within the permit area are subject to the <br />review procedures applicable to new permit applications, in accordance with Rule 2.08.5(1)(c) and <br />2.08.4. <br />For a renewal application to be deemed complete by the Division pursuant to C.R.S. 34-33-109(7), an <br />applicant must submit: (1) all information as specified on this application form; (2) a copy of the <br />newspaper notice; (3) evidence that a liability insurance policy will be provided for the proposed <br />period of renewal; and (4) five reproducible copies of the permit renewal application with original <br />signatures. <br />For federal mines, a copy of the renewal application must be submitted to all agencies on the federal <br />agency mailing list at the same time the application is submitted to the Division, and proof of <br />distribution must be submitted to the Division. Copies of renewal pages modified during the review <br />process must be distributed in the same manner, along with proof of distribution. Proof of <br />distribution must be submitted prior to implementation of the renewal. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly the appropriate information as listed below. Supplemental sheets may be used as <br />necessary. Such sheets must be attached to the form and referenced or keyed to the numbers on the <br />form. <br />1. Permittee: Hayden Gulch Terminal, Inc. <br />2. Name of Operation: Hamden Gulch Loadout <br />3. Permit Number (same as current permit number): -C-92-081 <br />4. Type of Revision: _R N Renewal Number: 0 3 <br />5. Application Submittal. Date: 11/21/97 <br />?_!