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-. . <br />• iii iiiiuiiniii iii <br />• <br />LIMITED I2~ACT AND SPECIAL (TEN-DAY) <br />__ PERMIT APPLICATION FORM <br />STATE OF COLORADO ~ ~~ ~" ~ ~ ~' ~ -- <br />Miaed Land Reclamation Board APplication far Ptiaing <br />Department of Natural Resources sad Reclamation Permit, <br />1313 Sherman Street, Room 723 ~~~f1R Z- ~5~a Pursuant to C.F..S. 1973, <br />Denver, Colorado 80203 34-32-101, et seq. <br />~Tl ii7 [t) LA`J~ Rt:i, L.?.iviA i iOiJ <br />P of Natural Resources <br />LItffTED II~ACT OPERAT16E~§~ ~t disturb LESS TI3AN tea acres (including all <br />roads, stockpile areas and say other surface facilities) over the life of <br />the mina, and must extract LESS THAN 70,000 tons of mineral, overburden <br />or combination thereof per calendar year. If the affected area is seme <br />fpaction greater than nine acres, ba sure NOT to round it up to ten acres <br />iA the narratives or elsevhere. <br />SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN tea <br />acres (including all roads, stockpile areas and say other surface <br />facilities), aac' can ONLY he abtaiaed vhern a federal, state, eouaty, <br />city, town, or special district contract calls for work to b• <br />commnaced vithia a SPECIFICALLY SHORT TIIg. <br />TYPE OR PRINT CLEARLY <br /> <br />1. Name of operations Open ~ri~-- Gravel <br /> (Pit, mine, or site same) <br />2. Name of applicant/operator <br /> (Name to ba used oa permit) <br />3 Address and phone number of e <br />. local offices <br />4. Address and phone number Same <br /> of general offices <br />5 Name sad phone number of person J.k. Owen <br />. staff members should contact - 7 or 743-2209 <br />6. Owner(s) of record of affected George Anslev <br /> land (surface area) <br /> (If more than 2, list below) <br />7 Owner(s) of substance to be Wined Same <br />. (If more than 2, list below) <br />8. Source of legal right co enter Oral contract - See "G" <br /> (Indicate whet type of proof is <br />iaeluded is Exhibit G - lease, deed, . <br /> notarized letter, etc.) <br /> e to be mixed <br />t <br />6 <br />b <br />i <br />f ~ "'"111101 from open nit. m; ne _ <br />9. anc <br />ne <br />su <br />s <br />m <br />Type o <br />(Specify underground, strip, open pit, <br /> etc. and substance(s) Co be mined) <br /> (Milos <br />i <br />l ~`"~`'~'~ ~~~~`~'~`"` ` ~ <br />.0. on <br />evat <br />Gaaeral location 6 e <br />S direction fron nearest town S -~• <br /> approximate site elevation) <br />Elevati n - 0' __ <br />;l. County ,~~ _ <br />i2. Acreage of affected loads Y ,tea <br /> (Total surface acreage to be <br />included is permit) <br />' <br />3: Application fee (See applicable Rule 35.00 <br />. to determine amount) <br /> <br />