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STATE Or' <br />DIVISION OF RECL*MATWN, MINING AND SAFETY ~,(~ "` <br />° ~~ <br />Departr~rtt of iJatural Resotuces /~ <br />13t3 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />~`' <br />PFtone: (303) 866.3567 /; "• ""+~ <br />FNt: (3031 s32-ata <br />V <br /> '~ ~~' <br />' <br />, '~~ <br />DESIGNATED MINING .. <br />;'ry <br />~.~„~w~vn <br /> , <br />LIMITED IMPACT (110d) OPERATION <br />COLORADO <br />DIVISION O! <br />RECLMAATION <br />MINING <br />SAFETY <br />Bill Rltter,ir. <br />Governor <br />RECLAMATION PERMIT APPLICATION FORM Harris D. shaman <br />Exeuative Diregor <br />Ronald W. Canny <br />Owision Director <br />CI~CK ONE: New Application (Rule t.a) ~ Amendment Application (Rule is or t.1o) ~„~ Resource7rurtee <br />Conversion Application (Ruse 1. i l ) <br />Permit # M- ~ 977 ~ ~ 6 - (provide for Amendments and Conversions of existng permits) <br />The application for a Limited Impact (1 lOd) Designated Mining Operation Reclamation Permit contains three major parts: (I) the application <br />forin; (2) Exhibits A-J, Exhibit L, Exhibit T, the Geotechnical Stability Exhibit, the Emergency Response Plan, and Addendum 1, as required by <br />the Office, and outlined in Roles 6.1, 6.2, 6.3, 6.4.20 6.5, 8, and 1.6.2(1 xb); and (3) the application fee. When you submit your appliption, be sure <br />to include one (1) signed and notarized Original and one (1) copy of the application form, two (2) copies of Exhibits A-J, Exhibit L, Exhibit T, the <br />Geotechnical Stability Exhibit (Rule 6.5), the Emergency Response Plan (Rule 8), and Addendum 1(Rute 1.6.2(1)(b)), as required, and a check for <br />the application fee described under (4) below. Exhibits should NOT be bound or in 3-ring binders; maps should be folded to 8 2" X 11 " or 8 2" X <br />14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ail information described below. <br />1. Applicant/operator or company came (name to be used on permit): DRt1lSOCi MIf1eS (USA) C©rp. <br />1.1 Type of organization (corporation, partnership, etc.): COrpOration <br />1.2 I.RS. Tax ID No. or Social Security Number: 1341 X72857 <br />2. Op eration name (oit, mine orsite name): Cafflatl011 MIt1e <br />3. Per mitted acreage (new.or.ezistin¢site): 9.76 permitted acres <br /> 3.1 Change in acreage (+) ~•~ acres <br /> Total Acreage in Permit Area 9.76 acres <br />4. Fees: (Rule l.5) <br /> 4.1 New Application 52.875.00 application fee <br /> 4.2 Amendment Fee (operations existing as of 06/30/94) 51.725.00 application fee <br /> 4.3 Amendment Fee (operations permitted from 07/01/94) S2.300.00 application fee <br /> 4.4 After July 1,1995, to convert a 110(1), 1 l 0(2) or a i 10 to a 110(d), a new application form fora 110d must be submitted, along <br /> with an application fee of 5.00 (Rule 1.11.2(2)). <br /> Ufa1'liWtllNRf}~di1Jl'i"1 <br />S. Pri mary commodities to be mined: <br /> ~ <br />fl <br />6. Tun , In-situ <br />, Surface 1~ Underground <br />e of minine operation: <br />Office of Office of <br />Mined land Reclamation Denver • Crand )unction • Durango Alive and Inactive Mines <br />