REV14934

• Permit No: M1977393
• IBM Index Class Name: Revision
• Doc Name: REGULAR 112 PERMIT APPLICATION FORM
• Type & Sequence: AM1
• Media Type: D
• Archive: No

~. -~=~
Ric nartl D Lamm
Govarnor
~ -- .- -- -~ ~, III IIIIIIIIIIIIIIII
DEPARTMENT OF NATURAL RESOURCES
D Monte Pascoe. ExecWi~e Director
MINED LAND RECLAMATIO~N~/a~, `~
DAVID O. SHELTON Director ~~~~'
~~ -
JAh.~
REGULAR (lI2) PERMIT APPLICATION
FORM ! F.~~~ ~_;~,l~~Se siF`';..+~a~~~" ,T-+~~
~cr ,rr..t:,
State of Colorado
Department of Natural Resources
MINED LAND RECLAAfATION BOARD AND DIVISION
1313 Sherman Street, Room 423
Denver, Colorado 80203 [phone] n1~"7'7-.39_3
(Type or Print Clearly)
Application for Mining and
Reclamation Permit:, Pursuant to
34-32-I01 et se ., C.R.S. 1973,
as amended
I Nam
of O
rati
. pe
e
on
(pit, mine or site name)
Jenkins Site
2. Name of Applicant/Operator Varra Companies, Inc.
(name to be used on permit)
3. Address and Phone Number of 2130 S. 96th Street
Local Office
Broomfield CO 80020
Address and Phone Number of 666-6657
General Office '
Same
5. Name and Phone Number of Person Car Tuttle Tuttle A le ate Rindahl, Inc.
Staff Members Should Contact 452-6611
6. Parent Corporation, If Any None
(include name and address)
7. Owner(s) of Record of Affected Varra Com antes Inc.
Land (surface area)
(if
li
t i
th
t
more
an
wo,
s
n
EXHIBIT P)
8. owner(s) of Substance to be Varra Companies, Inc.
:lined (if more than two, Zist
in EXHIBIT 2)
9. Source of Legal Right to Enter Notarized statement
(indicate what type of proof is
cluded in EXHIBIT O) See
i
n
34-32-112(2)(d)
0. Type of Mine and Substance to 0 en it a re ate
be Mined (specify underground,
o
it
uarr
and
en
etc
p
y,
p
, q
.
substance(s) to be mined)
423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. [phone]