2010-06-14_REVISION - M2007005

• Permit No: M2007005
• IBM Index Class Name: REVISION
• Doc Date: 6/14/2010
• Doc Name: Notices
• From: DRMS
• To: Various
• Type & Sequence: SL1
• Email Name: THM
• Media Type: D
• Archive: No

SPECIAL (111) OPERATION
STATE OF COLOMDO
DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources
1313 Sherman St., Room 215
Denver, Colorado 80203
Phone: [phone]
FAX: [phone]
CONSTRUCTION MATERIALS
COO
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REFCF-P
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Division OfR?20Qj
Mining and S., on,
RECLAMATION PERrMIT APPLICATION FORM
COLORADO
D t v l S I O N OF
RECLAMATION
MINING
SAFETY
Bill Owens
Governor
Russell George
fmculive Director
Ronald W. Cattany
DivWon Director
Natural Resource Trustee
The application fora Construction Materials Special 111 Operation Reclamation Permit contains four major parts: (1) the application form;
(2) Exhibits A-11, Addendum 1, and any sections of Exhibit 6.S (Geotechnical Stability Exhibit), as required by the Office, 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) cornpieterl signed and notarized ORIGINAL and one (1) copyof the completed
application form, two (2) copies of Exhibits A-L, Addendum 1, appropriate sections of Exhibit 6.5 (Geotechnieal Stability Exhibit), as
required, a check for the application fee described under (4) below, and the fully executedPerfomtance Warranty and Financial. Warranty, if
required. Exhibits should NOT be bound or in 3-ring binders; maps should be folded to 8 2" X 11" or 8 2" X 14" size. To expediter
processing, please provide the information in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, all Information described below
1• ADnlicarit/tlnerafar nr rmm?nnv nemn l..o...s ?? a., ._.._: __ .?_ _ ___. ...
1.1 Type of organization (corporation, partnership, etc.): 17-0/ /? han
2. Oaet'ation name fait, ring or site camel:
3. Permitted acreage: Permitted Acres
4. New Application•
5. Primary coramoditlefsl to be mined:
6. Name of owner to the surface of affected land-
7.
A12-1-99- Application Fee
Name of owner to the subsurface rights of affected land _
8. Type of mining operation: Surface Underground lu-situ
9. Location information: The center of the area where the majority of mining will occur:
COUNTY e2e-n&
PRINCIPAL MERIDIAN (check one): 6th (Colorado) 10th (New Mexico) ? Ute
SECTION (write number): S Z(d
TOWNSHIP (write number and check direction): T North Y' South
RANGE (write number and check direction): R f East y West
QUARTER SEC'T'ION (check one): NE ? NW SE SW
QUARTER/QUARTER SECTION (check one): NE r ? NW SE SW
GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the approximate elevation):
ec.1 17h"? IA& C'i) a
&Q, J7 u?zs
Office of
Mineei Land Reclamation Office of
Active and Inactive Mines