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iiiiiiiiiiiiiiiiiii -~„,I f~~rs~l- -~ ~as,7~ ~7 ~1Z,~;~W11--I° DocU~/121/2001 STATE OF ,,~ • DIVISION OF MINERALS AND GEOLOGY ~~ DePJnmenr of .4'amral Resnwres ~/p~~,o" J~~~QQ 171 3 Sherman Si.. Roam ! 13 ~/ '~/~J M1~'~i Denier, Colorado 80!U3 Phone: ~ Nl i~ 8hh-Sib: O~a'A p,~x ~ulraJ!-A106 APPLICATION FORM FOR A PERMIT 4u~.,, TO "Dr CONDUCT COAL MINING IN COLORADO RADO Application to conduct surface or underground coal mining activities or other surface coal mining and reclamation operations in Colorado pursuant to C.R.S. 34-33-101 et seq. II~~~_ DEPARTMFNi OI NATURAL RESOURCE` Rov Romer Gove.no~ lames S. Lochhead ERttutire Dirttror For an application to be deemed complete by the Division pursuant to C.R.S. Michael g Long 34-33-103(5) and Rule 1.04130), an applicant must: 11) supply all information as Division Director specified on this application form; 121 submit five reproducible copies of the permit application with original signatures; and (3) pay the appropriate fee required by Rule 2.01.6. For federal mines, please refer to the Federal Agency Mailing List available from the Division and provide one copy to each of the agencies on that list, at the same time the application is submitted to the Division. Proof of distribution to the federal agencies should accompany the application. Copies of application pages modified during the review process must be distributed in the same manner, along with proof of distribution. Please note that this form is only a listing of general category requirements and does not constitute a checklist of detailed permit application requirements. A finding of completeness should not be • interpreted to imply adequacy of an application. Additional information not listed on this form may be required for adequacy depending upon the individual circumstances of an application. After a decision has been reached on this application, the operator must update the permit application on file at DMG and OSM. For non-federal mines, one copy must be sent to OSM in Albuquerque, New Mexico. This form consists of two major parts: 11) a section entitled "Application General Operation Information: and (2) a section entitled "Application Requirements." Specific instructions for filling in the necessary information for each section appears immediately below the title of each section. GENERAL OPERATION INFORMATION Type or print clearly the appropriate information as listed below. Supplemental sheets may be used as necessary; such sheets must be attached to the form and referenced or keyed to the numbers on the form. 1. Application Number Ito be filled in by the Divisionl: C - 8 1 - 0 1 2 2. Permittee: P I C K E T W I R E - - - - - - - - - - - - - - - - F F. 0 C E S S I N G, L L. C - - - - - - - - - - - - - - 3. Mine/Site Name:_~ _ ''' E L :4. Current Permit Type: C O