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<br />999 <br />iCdL2 Jr GJlcranJ iC OI:C3tiCn .Jr :"~~^~ 3LG <br />_.. a?ardent of Sacur3l 3asources " ~ L ~7a2 3eclaaacion ?eraic, ~ursuaac <br />`'T'TJ _~.:ID ~.C:_.-`1~'_C:I ?G.~~.D CJ C35 1?i3, :+-32-1^.I, ec sec <br />'_J:3 she[~an street, Soon 423 114~NE6 LAIVO RECLAiYATION <br />Dz.::er, CG 80:03 (303) 834-J55- $2 - I Aq <br />_--. ^.-- ---_ -- .. _ . - i Hoof „s ni3~Hr'E~ R?98~o09 <br />:"ae £o1lJC:ing z.-.~lanaticas cover L:a'.^_ed Lanact a~oLic3c'_ons (LO's) and soec'_3i ('an- <br />Oa? Hrocessia3)(lll's) =_onL`cat=Jos. Lz the iaterasts ez a?:icie^_t ?rocessiag, ?I=_3se <br />caec'c t:~e anpronriate oJ~ co iad_cace :chic: t??e o= a?p'__c3t'_on ?ou ace ap?11:3 .Jr <br />here. I1_ 4er_ics na? be issued on'_? wader spec_a1 circ•~starces. 3z ;ore ?ou are <br />•~ L~'~~ =`*_'3C~ OP?'~S:C:iS nose d:.s~1=5 *~..SS ; _a:7 tan acres (iSCludl=.g 3i1 <br />_Jads, srccpile areas and aa? ocher surface tac'~'.ities) over t!:e L':_ Jc <br />the ni3e, and vast extract L::SS :F1.:7 10,000 cons of aineral, J•rerhurden or <br />c.^~',_^_acion chereo: ^er c3.Iendar year. i. the a?`ected area is seae :=aceiot <br />3=eater cSaa n_ae aces, ce sure VOt to round ~:is :'_~uce cu: tJ tea acres :a <br />t::e ta._sci•:es or elsewhere. <br />j ~ S?P_CuL (^_.;-f7.1? '?30C~.'SS~iG} operacioas crust distnrS ir.SS :°~:I c~ acres <br />U ('=.dudi.g all. roads, stoc.-p11L areas aad an? ocier sur_ace :adl'_t_es), <br />aad can OCILT 3e aotai=ed ~hete a °_zderai, sc3ta, c]un^:, c_r7, c~.nl or <br />sneci3l distr'-ct ceatract ca11s cor aor'c to ~e cocaencad •rlca~ a 52°-C~?C.~:.i.Y <br />(T_;ne Jr 2risc Clearl?) }{o2N~ NEt ~1'r <br />1. :Ia=e c= Joeracicn <br />(?'_t, ai.-.e or site Wane) <br />0 <br />T7,r -AU7w PiT.t/o7f( TH <br />?. ay=e c' ano'__c3nt/oneratar <br />(`;aae a Se wed on perait) <br />3. address and ~hoae aL..ber c: r/~'i r/~Ar.SoN%~ir!/N T~1' /)i S'T'~'2 ~A/3o;Y/L-2 <br />1OC31 Jtt _Ce5 I. ~. .. ~.. -_.. ... .. ...i~ .__ , ls_r~s-. ~__h:.o ~ . <br />z <br />+. address end ?hcne ac~her of d Q e <br />general Jrr-ces ~r/.•N~~ T/°'d. ~0~07 ~3~:3)3f/G-~r.38' <br />5. aa=e and ~hcae nuaber o= ?ersoa <br />sta. _° nears scou'_d ccrtact j <br />o. ~= er(s) J: reccrdof a:'ecteds~d I ~.ftrF/YG°~~/er/YUNfr' <br />(;::rt 3C3 ar23,(~t ~Jre C.aa 1, 1',t RIJw) !3O A.3 6 <br />?/.s.T2 Rd.4.~.sfr,{TTeN.~e, JJ J <br />". ~ -er(s) a: suostance tJ oe aimed <br />-_ =ar= _....n ', Iisc 'te1Ja) <br />J. SCL'rCe C. legal r'_3hL tJ enLe_ I <br />;.dicate .mat t?pe o= ?roo: is I P~l'M~SS ~ o/Y~reM ,C.4/t/U~oWNfY <br />i:.cl'idad :a =.~331T G -lease, j <br />deed, r_ocar'=ed leLLeL, etc.) <br />9. ---e oL -,{-e 5 suostance tJ be <br />~aed Csoec__? >~der~_cu=d, str'_~, . ~~/~ j~,~, <br />e?e; 4ic, ace. ~ su~scanee(s) c] f ---- <br />.0. ;eaer3l lJCatioa & e_eva-=cn <br />"i'es :: d_recc_on :rte te3rest <br />tc~-z s =_cproz=.ac~ site z:e•rat'_on) <br />'__. CJII:IC'• 1/'7l ~ ('iI 1"~5'oN C ~O Ul/TY _ <br />__. Cre33e CL 3______C L''_' <br />( CL~ iL'r=3te,3Cea3e'tJ ]e <br />_-. __e42^._ _'-... C52 (L.e. -r- lr /"A'.S'.~..~/Q ~/Oj <br />_-. ?rc:osed .,c_r_ _.::d we Ids'//.~NPi7i3Oi:^~'oy7iN01cdw.i~,nlap.FB,svy9To,3// <br />Slop,F ifdd/iv~~xri~/°s'oi/YPJANTJ'o r.ISS <br />;:..,ri <br />