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3 <br />General Description (Miles and direction from nearest town and approximate elevation): <br />Approximately 19 miles north of Loma, CO on SH -139. Elevation approximately 5610 feet. <br />Not for DP Ent <br />Permitted <br />Actual <br />Proposed <br />8. Mineral ownership: <br />Indicate currently ermined acreage for each <br />Federal: acres <br />2,400.5 <br />2,400.5 <br />0 <br />State: acres <br />0 <br />0 <br />0 <br />Private: acres <br />160 <br />160 <br />0 <br />Indian: acres <br />0 <br />0 <br />0 <br />9. Surface ownership: <br />Indicate currently ermined acreage for each <br />Federal: acres <br />2400.5 <br />2400.5 <br />0 <br />State: acres <br />0 <br />0 <br />0 <br />Private: acres <br />160 <br />160 <br />0 <br />Indian: acres <br />0 <br />0 <br />0 <br />10. Affected area in acres <br />1,903.1 <br />501 <br />0 <br />11. Disturbed area in acres <br />17.65 <br />12.9 <br />0 <br />12. Acreage of area reclaimed in previous permit term <br />A. Backfilled and graded <br />N/A <br />3.3 <br />N/A <br />B. Reto soiled <br />N/A <br />3.3 <br />N/A <br />C. Reseeded <br />N/A <br />3.3 <br />N/A <br />13. Acreage for which bond has been released <br />A. 60 percent <br />N/A <br />0.0 <br />N/A <br />B. 85 percent <br />N/A <br />0.0 <br />N/A <br />C. 100 percent <br />N/A <br />0.0 <br />N/A <br />14. Renewal Term Requested Years <br />N/A <br />N/A <br />5 <br />Note: If the application contains proposed (new) acreage, then a permit revision application <br />form must also be completed for those acreages. <br />15. Type of Mine (Check one): ✓ Underground _ Surface <br />Combined Surface and Underground <br />Loadout Other <br />