2009-05-15_PERMIT FILE - M2009023 ‎(2)‎

• Permit No: M2009023
• IBM Index Class Name: PERMIT FILE
• Doc Date: 5/15/2009
• Doc Name: Original application augment
• From: Nielsons Inc.
• To: DRMS
• Email Name: KAP
• Media Type: D
• Archive: No

DIVISION OF MINERALS AND GEOLOGY
DePdrmert of Nzirural Resources
1313 Sherman St.. Room 21 s
Denver. Colorado 80203
Phone: [phone]oi
FAX: [phone]
orta?t.to?( o,p?l?cc?fcun M-1999-c?8G>
Pit
STATE OF COLORADO
RECEIVED
MAY 2 2009
Division of Reclamatkw,
Minting and Safety
CONSTRUCTION MATERIALS
SPECIAL (111) OPERATION

RECLAtNIATION PERMIT APPLICATION FORM
??11tiERALS
o.
GEOLOGY
AT I CN
••t V.Y:•i?F:,Y
3?ii Qwons
Governor
Grog E_ Watcher
.xecutive Direc:or
Michael 3. Long
Direc:Or
The application for a Construction Materials Special 111 Operation Reclamation Permit contains four major pars: (1) the application form;
(2) Exhibits A-L, Addendum 1, and any sections of Exhibit 6.5 (Geotechnical Stability Exhibit), as required by the Office,'
ffice, and outlined in
Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); (3) the application fee; (4) the Performance Warranty and if required a Financial Warranty. When
you submit your application, be sure to include one (1) completed, signed and notarized IVORY ORIGINAL and one (1) copy of the
completed IVORY application form, two (2) copies of Exhibits A-L, Addendum 1, appropriate sections of Exhibit 6.5 (Geotechnical Stability
Exhibit), as required, a check for the application fee described under (4) below, and the fully executed Performance Warranty and Financial
Warranty, if required. Exhibits should NOT be bound or in 3-ring binders; maps should be folded to 8 V.-" X 11" or 8 t/--" X 14" size. To
expedite processing, please provide the information in the format and order described in this form.
GENERAL OPERATION INFORIVIATION
Type or print clearly, in the space provided, all information described below.
I. Aimlicant/operator or companv name (nqm. t„ he
%elso4r
T h G .
2.
3.
4.
5.
6.
7.
8.
9.
1.1 Type of organization (corporation, partnership, etc.): o n
1.2 I.R.S. Tax ID No. or Social Security Number:
O;eration name (pit mine or site Hamel ??/Lllla- ?if
Permitted acreage: -
New Anplication• Permitted Acres
4?/-C. 625.00 Application Fee
Primary commoditie{s) to be mined e-
Name of owner to the surface of affected land- G;/4
6.1 Names of the holders of any recorded easements on the affected land: /?/t
Name of owner to the subsurface rights of affected Iand: f 4T L -/-- fie,
Type o- =atl4n: -?' Surface Underground In-situ
Location information: The center of the area where the majority of mining wili occur:
COUNTY: L r, /047-r,
PRINCIPAL MERIDIAN (check one): 6th (Colorado) 10th (New Mexico) ____ Ute
SECTION (write number): S
TOWNSHIP (write number and check direction): T Norih
-South
RANGE (write number and check direction): R East Y West s?
QUARTER SECTION (check one): NE -NW SE 4% SW
QUARTER/QUARTER SECTION (check one): -NE _ NW _SE XSW
GENERAL DESCRIPTION: (miles and direction from nearest town and the approximate elevation)
/v;! LC t" %S 11llt-110t1 ,f/ek i