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SPECL1LyTEN-DAYD (111) ) aR`SIT III IIIIIIIIIIIII III
<br />• APPLICATION FOR`i~ sss
<br />i y-
<br />State of Colorado L y mis ~~ ~ Application for :Dining and
<br />Department of Natural Resources Reclamation Permit, pursuant
<br />t!IN"D LAND RECLa,`11TION BOARD to CRS 1973, 34-32-101, et s<q
<br />1313 Sherman Street, Room 423
<br />Deaver, CO 80203 (303) 839-3567
<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 />hero. 111 termits may be issued only under special circumstances. Be sure you are
<br />eligible.
<br />LL`DITED LSPACT OPERATIONS must disturb LESS TIi~+.N ten acres (including all
<br />/!4\ 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. Zf 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 />0 SPECIAL (TE.`1-DAY PROCESSING) operations must disturb LESS THA.`J ten acres
<br />(including all roads, stockpile areas and any other surface facilities),
<br />and can ONLY he 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 ~ < , -~ ~ "F~ (J
<br /> (Pit, mine or site same) ~
<br />i 1 ,~ '~:; .
<br />~Name3oc;~pPYicant/operator':.. .- - -~ -~ ~j ~ _ ~ ~-~
<br /> (Name to be used on permit)
<br />-~• ~
<br />~
<br />5
<br />3. Address and phone number of /)~ ) ~ (J~ c /,/u~~•
<br /> local offices -~ . -,
<br />-~ - ~.
<br />4. address and phone number of ~ "' ~ < .~
<br /> general offices
<br />5. PJame and phone number of person ' ~L~ ~ )! J' , , ~ ;~
<br /> staff members should contact ,- -s
<br />_ ~,
<br />, ~..
<br />~•
<br />6, Owner(s) of record of affected and ~ -~ ~ _
<br /> (surf aceazeaxIfaorethan2,lstbelow) - J)'~~r.,- , ~ •J,~
<br />7. Owner(s) of substance to be mined ~ ~~' ,' j
<br /> (If sore than 2, list below) `~ ~ -,
<br />~ ~. r:
<br />< ~.
<br /><
<br />8. Source o£ legal right to eater
<br />(Indicate what type of proof is
<br />" ~~
<br />r->(~ >>
<br />/E'.~~
<br />C~~ ~ ~~.f. ('
<br /> included in EXHIBIT G - lease,
<br />deed, notarized letter, etc. ) l
<br />'1 l ~C L: <, ~ _
<br />~(~
<br />9. Type of mine & substance to be '
<br />mined (Specify underground, strip, ~~~/~'~~ j ~p ,lyr'.
<br />S;;open pit, etc. b substance(s) to
<br />- ' ' be mined)
<br />30. General location b elevation -';~
<br />JZ '
<br />J `
<br /> (Miles b direction from nearest
<br />
<br />
<br />town 6 approximate site elevation) i
<br />.. C'
<br /> _~J
<br />11. Cannty
<br />-.~
<br />12. Acreage of affected lands
<br /> (Total surface acreage to be ~
<br /> included in permit) `~ f~~, k~F~ ~
<br />13. application fee (See applicable
<br />~
<br />~
<br /> RLTI.E to determine amount) ~ G' rc:
<br />t
<br />14. Present land use (i.e., Agri- ~ `~ L ~%?~
<br /> cultural, industrial, etc.)
<br />
<br />~15..
<br />Preposed future land use i _
<br />• ~' , (Goal of .reclamation) r i c_, , , - { , ~/
<br />i
<br />
<br />(over)
<br />
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