Town of Fairplay Gold Panning Permit Application

1 Town of Fairplay PO Box 267 Fairplay , CO (719) 836-2622 Town of FairplayGold Panning PermitApplicationPermits arevalid from April options are as follows, please select one:_____$10/day/person,indicateday(s)of use_____(Children 12 years old and younger are free when accompanied by a permitted adult.)_____$100/year, unlimited use between April and October of current yearPlease make checkspayable totheTown ofApplicant:_____Applicant sMailingAddress, City, State, Zip:_____Gold Panning Rules and shall be limited to individual gold Panning by persons using hand tools, consisting ofa shovel and a gold pan and to gravity flow sluices. All other mechanical, electrical or handpump sluice devices are prohibited and shall be subject to confiscation by the whichgold Panning is allowed will be designated by rocks or earth may be removed from the site, except those materials which theindividual believes to containgold.

2 In no event shall material in excess of one (1)gallon beremoved from the shall be conducted in such a manner as to leave theGold Panning Area, asdesignated by signage along the Middle Fork of the South Platte River as it runs through theTown of Fairplay corporate limits, intact and FOR VIOLATION(S): Anyone found violating these rules and regulations shall besubject to a fine of up to $2, per violation, with a MINIMUM penalty of $ shall also be made to the Town for all damageto READ AND SIGN:I, the undersigned, have read and agree to the rules and regulations noted above and assume allresponsibility in regard to my actionsand my safety while gold Panning on Town property and holdthe Town of Fairplay : _____Date: _____Permit must be in the panner s possession when Panning . Permit is non-transferrable.**Issued by: _____Date:_____Amount Paid:_____Method ofPayment:_____