2011-04-27_PERMIT FILE - M2011026

• Permit No: M2011026
• IBM Index Class Name: PERMIT FILE
• Doc Date: 4/27/2011
• Doc Name: New 112c application
• From: Keyah Grande Lodge and Elk Ranch
• To: DRMS
• Email Name: KAP
• Media Type: D
• Archive: No

(10.) Primary Mine Entrance Location (report in either Latitude/Longitude OR UTM):
Latitude/Longitude:
Example: (N) 39° 44'12.98"
(W) 104° 59' 3.87"
Latitude (1):
Longitude (W):
OR
37° 14'15.00"
107° 14'15.00"
Example: (N) 39.73691-
(W) -104.984490
Latitude (I): 37.23750 (5 decimal places)
Longitude (W): -106.76250 (5 decimal places)
OR
Universal Transverse Mercator (UTM)
Example: 201336.3 E NAD27 Zone 13 439835].2 N
UTM Datum (specify NAD27, NAD83 or WGS 84) Zone
Easting
Northing
(11.) Correspondence Information:
Ll, APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Mr. Keefer Rader Title: Ranch Manager
Company Name: Keyah Grande Lodge and Elk Ranch
Street/P.O. Box: 13211 Highway 160 West P.O. Box:
City: Pa og sa Springs
State: Colorado Zip Code: 81147
Telephone Number: [phone]
Fax Number: [phone]
PERMITTING CONTACT (if different from applicant/operator above) same as above
•>
Contact's Name: L ?, n? Cccs?y Title:
Company Name:
Street/P.O. Box: s ss V e %z k t- u B i- t P.O Box:
City: 0vr, •l5c'
State: (;, ?K J o Zip Code: l U I
Telephone Number: (K7G) d-S `I - tS y5
Fax Number: (q 70) 1 s y - o tf
INSPECTION CONTACT same as above for APPLICANT/OPERATOR
Contact's Name: 111'14 Title:
Company Name: