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' n DIVISION OF MINERALS AND GEOLOGY ��-eT'E OF COLORADO <br /> ✓ 1111111111111111111 <br /> Department of Natural Resources 999 RECEIVE <br /> 1313 Sherman St., Room 215 PWi <br /> Denver,Colorado 80203 <br /> Phone:13)8 2-8100 MAR 0 6 2001 <br /> FAX:(303)8:32-8106 <br /> r ' c ✓ Division of Minerals and Geolo DEPARTMENT OF <br /> gy NATURAL <br /> f 4-7-7 q �y vim` REGULAR (112d) DESIGNATED MINING OPERATION RESOURCES <br /> Roy Romer <br /> Ue Loo"- RECLAMATION PERMIT <br /> Governor <br /> re FJja.Ct M6JAPPLICATION FORM lames S.Lochhead <br /> ✓ Executive Director <br /> Michael B.Long <br /> Division Director <br /> CHECK ONE: New Application (Rule 1.4.5) X Amendment Application (Rule 1.10) <br /> Conversion Application (Rule 1.11) A4345Z D <br /> Permit No. M- 7-7 - 4q? (provide for amendments and conversions of <br /> existing permits) <br /> The application for a Regular (112d) Designated Mining Operation Reclamation Permit <br /> contains three major parts: (1) the application form; (2) Exhibits A-T, Geotechnical <br /> Stability Exhibit, the Emergency Response Plan, and Addendum 1, as required by the Office, <br /> and outlined in Rules 6. 1, 6.2, 6.3, 6. 4 . 19, 6.5, 8.0, and 1. 6.2 (1) (b) ; and, (3) the <br /> application fee. When you submit your application, be sure to include one (1) signed and <br /> notarized Gray original and four (4) copies of the application form, five (5) copies of <br /> Exhibits A-T, Rule 6.5 Geotechnical Stability Exhibit, the Emergency Response Plan, <br /> Addendum 1, and a check for the appropriate application fee (described under Section (4) <br /> on Page 2) . Exhibits should not be bound or in a 3-ring binders; maps should be folded <br /> to 8 31" X 11" or 8 4-!�" X 14" size. To expedite processing, please provide the information <br /> in the format and order described in this form. <br /> ---------- <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly, in the space provided, all information described below. <br /> 1. Ap4licant/oRerator or company name (name to be used on permit) <br /> 1. 1 Type of organization (corporation, partnership, etc. ) : <br /> 1.2 I.R.S. Tax ID No. or Social Security Number:. If,—/-/-9"'(0?/-86 16 <br /> 2 . Operation name (pi.t mine or site name) : &I"4-l`¢y- 1plIA-ev <br /> 3. Permitted aereaQe: (new or existing site) 4t5r7-1 v permitted acres <br /> 3. 1 Change in acreage (+ or -) 10,Z-acres 46- <br /> 3.2 Total acreage in Permit area acres <br />