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7/78 ~ ~MITED IMPACt (110) and •1 ~ III IIIIIIIII'III'll
<br />~- SPECIAL TEN-DAY (111) PERMIT ses ,-
<br />APPLICATION FORM
<br />State of Colorado ~~~~~~ D' Application for Mining and
<br />Department of Natural Resources '~s;,. Reclamation Permit, pursuant
<br />MINED LAND RECLAMATION BOARD D E C~~:Y.;: ,;•. to CRS 1973, 34-32-101, et seq
<br />1313 Sherman Street, Room 723 - ,
<br />Denver, CO 80203 (303) 839-3567 RECLAiVIAfI SECTION' - -
<br />~A~6 L4N} pl„Nytilral ~N<nIIrcPS
<br />The following explanations cover Limited Impact appll:caYions (110s) and Special (Ten-,.-
<br />Day Processing)(llls) applications. In the interests of efficient processing, please
<br />check the appropriate box to indicate which type of application you are applying for here.
<br />LIMITED IMPACT OPERATIONS must disturb LESS THAN 'ten acres (including
<br />all roads, stockpile areas and any other surface facilities) over the -
<br />life of the mine, and must extract LESS THAN 70,000 tons of mineral, '""!_
<br />overburden or combination thereof per calendar year. If the affected ~`'`'' •
<br />area is some fraction greater than nine acres, be sure NOT to round this _ .
<br />figure out to ten acres in the narratives or elsewhere.
<br />SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN ten acres
<br />(including all roads, stockpile areas and any other surface facilities),
<br />and can ONLY be obtained where a federal, state, county, city, town or
<br />special district contract calls for work to be commenced within.a - -•
<br />SPECIFICALLY SHORT.7IME.
<br />(Type or Print Clearly) ~l J `i /y~~
<br /> Y
<br />1 . Name of operation . T- L "'~"
<br />
<br /> (Pit, mine or site name)
<br />E CfLf/.9r~/ ~pLO. &~~iB
<br />2. Name of applicant/operator ~ n // ~T ..r
<br />
<br /> (Name to be used on permit)
<br />3. Address and phone number of ^/~7 r^,/-,-~/~ V ~ (~/~. SOR/N6 {
<br />~~~
<br /> local offices
<br />_. - 4~/-.~~ ~ ~9c
<br />4. Address and phone number of ~/~ ~ Ry//~"D ~nLn. ~SPR/ r S . ~ lc
<br /> general offices - -_.
<br />
<br />5. Name and phone number of person /v/i~ X ~ ~n ~ ~ r ~ ~/ -
<br /> staff members should contact
<br /> ~/ - . ~~~~
<br />6. Owner(s) of record of affected
<br />'
<br /> land (surface area) (if more f,.~. -~. /~? jT
<br /> than 2, list below)
<br />7. Owner(s) of substance to be mined (~ ~ /7- - _ ..
<br /> li
<br /> (If more than 2,
<br />st below)
<br />
<br />8. Source of legal right to enter -' ~ ~ •~' ~' ° ~ '
<br /> (Indicate what type of proof is ~j~- FX/,// '
<br /> included in EXHIBIT G - lease,
<br /> deed, notarized letter, etc.) -
<br />~-
<br />~`~-
<br />, ;
<br /> ,,, .
<br />,
<br />. ,- - _,
<br />,, ,~___ ._
<br />.
<br />9. Type of mine 6 substance to be, ~: ~. . • , - r,r, ~
<br />
<br />/ ~
<br />^~ -
<br />T r-
<br /> mined (Specify underground, strip, ~1T / / ~. •. R (
<br />P,F/(
<br />~ .~~
<br /> open pit, etc. E substance(s) to ~ •
<br /> be mined) ". :,°''"---'
<br />10. General location S elevation r-,_ . ~ i.. ~.,~......a. -,.y, ~.- ._JD-_ ~. nb O:.YG7 ~{~1
<br /> (Miles b direct ion from nearest ~F T/-~~~/~.~ ~ .Q ~^•-
<br /> _ _
<br />town b approximate site eleva-.'
<br />` //p~~, ~ -
<br />~JC
<br />~
<br />~~re
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<br /> lion) - - -
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<br />County -~-~--• 7~ ~
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<br />.CLrJ~Ai~~ ~ 1 _ ~,
<br />~~. aJ.
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<br />12. Acreage of affected lands ~/~/S'WDULD ~~P~NI] D/I/"AGrTS!
<br /> (Total surface acreage to be ,,. ,,,
<br />included in errnlt /~
<br />~~ /-.6 ;I, - .I°"~ °- ~c °':
<br />• ~""'"
<br />13. Application fee .(See. appl icable._ _,~c~s_. °-o ~/US ~'~~ ~~~!!C!RC
<br /> RULE to determine amount) / / / rn ~ F n/
<br />
<br />~ C'
<br />
<br />(over)
<br />
<br />~%
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