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. T <br />-2- <br />0 <br />3. Address and Phone Numoer of P,0 Box 721, Lamar, CO 811052 <br />Local Offices Tele: 303 - 336 -9416 <br />4. address and Phone Number of <br />General Offices Same <br />5. Name and Phone Number of Person Ira Paulin or John Carderi <br />Staff Memoers Should Contact Tele: 303 -336 -9416 �3 - ✓,� <br />b. Owner(s) of Record of Affected Land Harold L. Hoffm & Bonnie J. Earl <br />(surface area) (If more than '2, list below) <br />7. UIf m rj of n 2, list be be sKined Harold L. Hoffman & Bon�ie J. Earl <br />(If more than 2, list below) <br />8. Source of Legal Right -To -Enter <br />( Indicate what type of proof is Lease <br />included in EXHI3IT G - lease, <br />deed, notarizea letter, etc.) <br />9. Type of Mine and Substance to oe Mined <br />(Specify underground, open pit, Open Pit Sand & Gravel <br />quarry, etc. & suostance(s) to <br />oe mined) <br />1U. General Location and Elevation 3 miles south & 1 mile e st of <br />(Miles & direction from nearest McClave, Colorado @ 750, <br />town & approximate site elevation) <br />11. County Bent <br />12. Acreage of affected Lands 9.9+ acres <br />(Total surface acreage to be <br />included in permit) <br />13. Application Fee (See applicable $125.00 <br />Rule to determine amount) <br />