PERMFILE57860

• Permit No: M1995057
• IBM Index Class Name: Permit File
• Doc Date: 8/22/1995
• Doc Name: LIMITED IMPACT OPERATION 110 2 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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~I ~ TED IMPACT OPERATION (110(2)
RECLAMATION PERMIT
APPLICATION FORM
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CfD;CK ONE: (~~PA~Yication (Rule 1.4) _ Amendment Application (C.R.S. 34-32.5-11D)
pivisionol Conversion Application (Rule 1.11)
~ECEIV~6
SEP ~ 1P~~t # M- - (provide for amendments and conversions of
existing permits)
t ~meralS 8 Geo~ogy
~)Y~~~Iication for a Limited impact Mining Operation Reclamation Permit contains three major
parts: (1) the application form; (2) Exhibits A-J, Addendum 1, any sections of Exhibit S and
Geotechnical Stability fixhibit, as required by the Office, and outlined in Rules 6.1, 6.2,
6.3, 6.4.19 and 6.5; and (3) the application fee. When you submit your application, be sure
to include one (1) sicmed and notarized orioinal and one (1) copy of the application form,
two (2) copies of Exhibits A-J, appropriate sections of 6.4.19 Exhibit S and 6.5
(Geotechnical Stability Hxhibit), as required, and a check for the application fee described
under (4) below. Exhibits should not be bound or in a 3-ring binder; maps should be folded
*_0 8 1!3" X 11^ or A 1/2" X 14" size. To expedite processing, please provide the information
in the format and order described in this form. '~~ ^~
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, all information described below.
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1. Applicant/operator or company name (name to be us d on permit):
1.1 Type of organization (corporation, partnership, etc.).</1N~/i!/i0i//s'~
1.2 I.R.S. Tax ID No. or Social Security N,pum~ber: 21CY~ ~o~-~O9~2
2. Operation name (pit, mine or site name): IWQI(~HL/(9N PST
3- Permitted acreage (new or existing site): ~~ 4~OU permitted acres
3.1 Change in acreage (+ or -) acres
Total Acreage in Permit Area ~ q~0 B' acres
4. Fees:
4.1 New Application 5875.00 application fee
Amendment Fee (C.R.S. 34-32.5-125 (II)) 5575.00 application fee
4.2 Conversion Fee (from 110d to 110 5875.00 conversion fee (Rule 1.11.2(2))
5. Primary commoditie (s) to be mined: G,P.i9~~TCT /eOC,i[ App6G~Ep(~19TC~.S
6. Name o£ owner of the subsurface rights of affected/land: O/~Na y ~a101(yR//GN
7. Name of owner of the surface of affected land: ~a4~/ IeN~i({gN~aN
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8. Type of mining operation: :Y Surface IInderground In-situ
9. Location information. The center o£ the area where the majority of mining will
occur lies in: COTJfTfy. GLII~/iJ~,S011J
P
PRINCIPAL MERIDIAN (Check one): 6th (Colorado) ~ lOthf New Mexico) Dte
SECTION (write number): S
TOWNSHIP (write number and check direction): T ~9 ~ North South
RANGE (write number and check direction): R ~_ ~ East West
QOARTER SECTION (check one) : 5E%yi/WY~ ''~~ NE X Nw SE ~, Sw
QOARTER/QOARTER SECTION (check one): SW /y NE ~~ ~ ~ NW _' SE X SW
GENERAL DESCRIPTION: (the number of mil~errs and direcCtion from the neairest town and
the approximate elevation) 83,50 /'EEr c"1~~~~°n. N ~qe~„J
ORIGINAL