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Corrected as of 15 August ' 8, <br /> Application Form for a Perm-it <br /> to <br /> Conduct Coal Mining in Colorado <br /> State of Colorado RECEIVED Application to conduct sur=ace <br /> Department of Natural Resources or underground coal mining <br /> .MINED LAND RECLAMATION DIVISION activities or other surface coal <br /> 1313 Sherman Street, Room 423 AUG1� 4 mining and reclamation operations <br /> Denver, Colorado 80203 (303)83���h�E in RECLAMATION dlVPSIin Colorado pursuant to CRS 1973, <br /> 0-33-101, et. seq. <br /> Coto. Dept. of Natural Resources <br /> For an application to be deemed complete by the Division pursuant to CRS 1973, <br /> 34-33-103 (5) and Rule 1.04 (30) , an applicant must: (1) supply all information- as <br /> specified on this application form; (2) submit five reproducible copies of the permit <br /> application with original signatures; and (3) pay the appropriate fee required by <br /> Rule 2.01.6. <br /> Please note that this form is only a listing of general category requirements and <br /> does not constitute a checklist of detailed permit application requirements. A <br /> finding of completeness should not be interpreted to imply adequacy of an appli- <br /> cation. Addtional information not listed on this form may be required for ademsacy <br /> depending upon the individual circumstances of an application. <br /> This form consists of two major parts: (1) a section entitled General Operation <br /> Information and (2) a section entitled Application Requirements. Specific instruc- <br /> tions for filling in the necessary information for each section appears immediately <br /> below the title of each section. <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly the appropriate information as listed below. Supplemental <br /> sheets may be used as necessary, such sheets must be attached to the form and re- <br /> feronced or keyed to the numbers on the form. <br /> 1. Name of Operation Mid-Continent Resources , Inc . <br /> (Pit, mine or site name) Coal Basin Mining Operation <br /> 2. Name of Applicant <br /> (Name to be used on permit - Mid-Continent Resources , Inc . <br /> the permittee) <br /> 2a. Address and phone number of P . 0 . B o x 158 , Carbondale, <br /> local offices Colorado 81623 Phone: (303) 963-2581 <br /> 2b. Address and phone number of <br /> veneral offices. same as 2a <br /> `lame and phone number of person <br /> George Wear (303) 945-5956 <br /> sta__ members should contact Doug Bowman (303) 963-?581 <br /> f <br />