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<br />State of Colorado <br />Department of Natural Resources <br />MINED LAND RECLaMe1TI0N BOARD <br />1313 Sherman Street, Room 723 <br />Denver, CO 80203 (303) 839-3567 <br />pp ica o n ng <br />Reclamation Permit, pursuant <br />~,I: 1 1950 to CRS 1973, 34-32-101, et seq <br />F;' I e 1\l 0 <br />'D- ~ `~~ <br />The following explanations cover Limited Impact applications (110 s) and Special (Ten- <br />Day Processing)(111's) applications. In the interests of efficient processing, please <br />check the appropriate box to indicate which type of application you are applying for <br />here. 111 permits may be issued only under special circumstances. Be sure you are <br />eligible. <br />L.J LL`SITED I`~ACT OPERATIONS must disturb LESS THAN ten acres (including all <br />u roads, stockpile areas and any other surface facilities) over the life of <br />the mine, and must extract LESS THAN 70,000 tons of mineral, overburden or <br />combination thereof per calendar year. If the affected area is some fraction <br />greater than nine acres, be sure NOT to round this figure out to ten acres in <br />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 SPECIFICALLY <br />SHORT TL*tE. <br />(Type or Print Clearly) <br />1. Name of operation s <br /> (Pit, mine or site name) <br />2. Vane of applicantloperator <br /> (Name to be used on permit) <br />3. Address and phone number of .0. Box 1 Crai Colo. 8162 <br /> local offices Phone 82 -7828 <br />4. Address and phone number of <br /> general offices g"L~X$}4~S~dZZ~$XXB%SF7~ffi4EffiE <br />5. Name and phone number of person Jim Showalter 824_6466 <br /> staff members should contact <br />6, Owner(;) of record of affected ]and <br /> (surface azea)(Ifmorethan2, list below) <br />7. Owner(s) of substance to be mined <br /> (If more than 2, list below) <br />S. Source of legal right to enter <br />(Indicate what type of proof is <br />Lease From Owrier <br /> included in E:DiIBIT G - lease, <br />deed, notarized letter, etc.) <br />9. Type of mine & substance to be <br />mined (Specify underground, strip, <br />Open cut for gravel and Road Construction <br /> open pit, etc. & substance(s) to <br />be mined) <br />Material. <br />i0. General location s elevation <br />& d <br />i <br />f <br />` <br />l 62 Miles East of Craig vn ifiwa7 394 <br /> rom nearest <br />es <br />irect <br />on <br />( <br />Li <br />town & approximate site elevation) <br />Elevation 6300 <br />11. County Moffat <br />I2. Acreage of affected lands <br />(Total surface acreage to be <br />included in permit) <br /> <br />9.$'j ACres <br />13. application fee (See applicable <br />RULE to deteraine aaount) <br />$125.00 <br />i». Present land use (i.e., agri- Agricultural, Dry land farming <br /> cultural, industrial, etc.) <br />15. Prcoosed future land use Agricultural Dr Land Fannin <br /> (Goal of reclamation) <br />(over) <br />L1`4ITED 1:4PACT (110) and / <br />SPEC APPLICATION (FO&`'1 PERMIT. I ~~ as III'II'lI1lI"II'II <br />~~'~~'° "~ `~ ~"""~ A 1' ti n for Mi i and <br />r <br />