PERMFILE101852

• Permit No: M1978305
• IBM Index Class Name: Permit File
• Doc Date: 9/25/1978
• Doc Name: LIMITED IMPACT AND SPECIAL TEN DAY PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

•.. y- II I I II I II I II IIII III LIMZZACi AND ISPECTAL (TEV-DA I ~.~ ~v
PERMIT APPLICATZON FORM ~ C~~~~() ~,5' ~
STATE OF COLORADO ~ ~-~`~~' ' " ~ Application for 4fiaing
ritaed Laad Reclamation Board sad Reclamation Permit,
Department of Natural Resources SEA' 2 ~ 1918 Pursuant to C.R.S. 1973,
1313 Sherman Street, Room 723 34-32-101, et seq.
Deaver, Colorado 80203
MIS!=~ LP.~!D R:=C! P.i:~iA?IOid
~„ r oni. r N,h~.~j P.95C~'TC~S
LL'~TED LKPACT OPERATIOISS'~mu~t d'19Eiirb LESS TARN ten acres (including all
roads, stockpile areas sad any other surface facilities) over the Iifa of _.____
the mine, sad must extract LESS THAN 70,000 tons of mineral, overburden
or combination thereof per calendar gear. If the affected area is some
fraction greater than nice acres, be sort NOT to round it up to tea acres
iit the narratives or elsewhere.
SPECIAL (TEN-DAY PROCESSING) aparations moat disturb._LESS THAN tea..____._._.___
____ .__,____ acres. _(including_all roads, stockpile areas and any other aurfaca•
facilities), and can ONLY be obtained where a federal,_state,__caunty.,.. _____.__.,.
__..__.__.._~_.Vcity_~. tava~ or. special district contract calls for work to ba
commenced within a SPECIFICALLY SAORT TTME. __..+^_~_____.,___..__,______ __
-- ------ - - - - TYPE OR PRINT CLEARLY F . 7 - 3O~
1. Name of operations R 11 K ~ (L So%G ~ QA N ITS, i~IT _
___ _ (Pitt mine, _or_site Hama) p /J
~~% ~ti r 1 e S (n~ e Sr O t ,7( juNN/SOS/
Z. Name of applicant/operator Fo2/YJAZ c`f~jo.J J.vC.
(Name to be used as permit)
r/NNi~a.c/ fn .
3. Address sad phone number of /CT' ~'~ ~d k /yA UJe5T ~UAIIV/Son
local offices / _ s /_ 3y7Z
4. Address sad phone number S~gmC AS LUCAL o~'~cc
of general afficea
5. Name sad phone number of person ~L. eGUi S ~o,2/nAL Q,~ ~o•(•o,po /47.AT
staff members should contact ~ /05//" ,~~7:2. Dom' ~o4U -095(0
5. Oaner(s) of record of affected ( '-p pr I ~ `p r~? ke R Sn ~l
land (surf ace area) (~ /, ;v7-o.V ~L1 r c k r e sc~.~l
(If more than 2, list below)
7. Owner(s) of substance to ba mined
(If more thaw 2, list below)
8. Sourea of lesal tight to enter L 6Ase ~ ~~
(Indicate what type of proof is
included is Exhibit G,- learn, dead, •
notarized letter, etc.)
9. Type of mine & substaaca to be mined ~D BN ~,r7
(Specify underground, strip, open pit,
etc. sad substance(s) to ba mined)
10. General location 6 elevation (`4i].es ~5i2 rn i 1~5 r,~~e5T ~civv~sov
li direction from nearest town b ~70~ y-EET
approximate site elevation)
I1• County / /1/i50ic/
L. Acreage of affected lands /Q ~ ~, Q~
(Total surface acreage to be
included in permit) ~
13: Application fee (See applicable Rule .~~~$ oo
to determine amount)