Laserfiche WebLink
<br />DIVISION OF MINERALS AND GEOLOGY <br />Orpunnmm,ri Nanusl Resources <br />III Shuuti.m $L, RnUm _' I i <br />Oem rr. C~th v.td,t n11!n.7 <br />Phun,~: 1111 II ' AL~ 1 ih; <br />F.\x. JnJI ll ~~'>Ved <br />~-~~ CMCOLORP~DO <br />III IIIIIIIIIIIIIIII o <br />SCF ~ 1 2~D~ R6CU LAR (1IO~OPERAT10iVS <br />O~F;C~, pIVISION t <br />F~ MINERAL <br />dt-~ <br />GEOLOG <br />0.ECLAMATIC <br />rtINING•$A FE~ <br />RECLAMATION PERMIT APPLICATION FORM 911 Ovvem <br />pe~~9o Field Cuvernor <br />Division of DK~9 Gex E. watcher <br />fYIIrlpldi5 $ (~`eo1~ E,rculive Direnor <br />CHECF; ONE: _ New Application (Rutz I.a.S) ~ Amendment Application (Rule l.lpb"cn.,el s. to~x <br />ivision Oueclor <br />Conversion Application (Rule I.1 I ) <br />Permit # tit -~-Q~,~-_ (providz for .Amendments and Conversions of existing permia) <br />The application for a CnnSULCTIpn Materials Ragular 112 Operation Reclamation Permit contains three major parts: (I) the application form; <br />(?)Exhibits ,4-S, Addendum (,any sections of Exhibit 6.5 (Gzotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be surz ro include one (I) c rmpletz si~rled and notarized IVORY ORICIYAL and four (4) copies of the completed Ivory <br />application form, five (~) copies of Exhibits A-5, Addzndum 1, appropriate sections of 6.5 {Geotechnical Stability Exhibit, and a check for <br />[he application foe described under Szaion (4) below. E.ehibia should NOT be bound or in a 3•ring binder; maps should be folded to <br />8 I/2" \ I 1 " or 8 1/?" ;( ! •1"size. 7o expedite processing, pleye provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, ip the space provided, ALL information requested below. <br />I. Apolicantloperator or company name (name to 6e used nn permit): <br />1.1 Typz of organization (corporation, partnership, etc.): Dr P ! /K l~pv C n. <br />I.Z [.R.S. Tax LD. No. or Social Security Number: ~r-,a~rS - ~{ t/ - 5 ~j 3 <br />~/I ~i- <br />?. Operation name (pit, mine or site name): RaCr= d''YGr fS <br />3. Permitted acreage (new or existing sitel: <br />3.1 Changz in acreage (+) <br />33 Total acreage in Permit aria <br />4. Fees: <br />4.1 New Application <br />~? New Quarry Application <br />4.3 bfilling Application (Non-DbIU) <br />;.S Amendment Fee <br />1.5 Conversion to 1 1? operation (>el by statute) <br />3 , S - ~~ 2.,r'~+rr-- permitted acres <br />l~, ~ j.~ ~ ~ /~, ~ r acres <br />55.3 5 <br />acres <br />31.875.00 application fee <br />5?.3?5.00 quarry application <br />53.100.00 milling application <br />SI.550.00 amendment fez <br />51.875.00 conversion fee <br />5. Primary commoditie(s) lp he mined: ~ U %' ~~ /SY~ h °Yy~r~ <br />S.I Incidental commoditie(s) to bz mined: I. Ibs/fonslvr ?. / Ibs/i'onslvr <br />3. / Ibslfom.:vr d. / Ibs/l'ons/vr 5. / Ibs/Tons/vr <br />:.? An[icipatrd end use of primary commoditie(s) to be mined: <br />~.3 Amicipatzd end use of incidrntal commoditiz(s) to be mined: <br />