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\JeX'sl oi,(- <br />11CGULAR UPERA•i 1OFJ (1 I;' ) <br />RECLAMATION PERMIT <br />APPLICATION FORM <br />-AAnd <br />M,ne° v 0 ;`''°11 <br />aBG,art-0Ot1 <br />the application fur a Regular Oper•cr1'1cn Reclamation Permit contains three major parts: , r <br />('I) the appl isration form; (r) Exhibits A• -S; and, (3) the application fee. When you 't.. <br />submit your application, be sure to include five (5) signed copies of the application <br />form , five (5) copies of Exhibits A -S, and a check friFtiie application fee described , ` <br />under (3) below. 10 expedite processing, please prov ide the information in the format i t" <br />and order described in this form, in _ EC( = joy-` 055 <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described be1ow. <br />1 . Appl •i cant./operator rrarrre: Pete Lien & Sons, Inc. <br />'I.1 Type of oryaniz:)tion (corporation, partnership, etc.): Corporation <br />2. Operation name (pi t., mine or si te name): Weaver Quarry <br />2.1 I.R.S. Tax ID tio. or Social Security 1.10.: <br />3. Application fee for permitted acreagek _122_ permitted acres <br />($50.00 •r $15,00/acre, 1st. 50 acres; <br />1,10.00/acre, 2nd. 50 acres; $5.00/acre, 3rd. 50 acres; <br />• 11.00/acre, any additional acreage; maximum fee of $2,000.00)* <br />Nolte permitted acreage and application fee and <br />attach a check For this amount when you I i I e . 14.4.19Q__. <br />4. Substance(s) to be ,Wined (e.g., gravel/gold/borrow): <br />5. Name of owner of surface of affected 1 and+ <br />6. Name of cwner of subsurface rights of affected land+ <br />application fr'c <br />7. Type of mining operation: Surface Underground In-situ <br />8. Location Information: the center of the area where the najori ty of mining will <br />occur lies in: <br />COUl D : Tari�,r <br />PRINCIPAL t•1ERIDIA*l (check one): -� 5th (Colorado) 10th (New Mexico) Lite <br />TOWNSHIP (wri te number and check di rec tion) : T ;{ Worth -Sou th <br />R69 " <br />East { West . <br />S 7.,8,18 <br />ir=NodN11 <br />RANGE (wri te number and check r11rection): <br />SECTION (wri te number): <br />QUARTER SECTION ciec one_p: <br />QUARTER/QUARTER SE ON ( ecr: oneJ ) <br />GENERAL_ DESCRIPTION: <br />(miles and direction <br />from nearest town and <br />approximate elevation) <br />(crow flies) N. of LaPorte. Elevation approximately <br />6000 feet. <br />If the operator is a unit of state or county government, an application fee is not <br />required. A fraction of an acre must be counted as one'acre for fee calculation. <br />+ If 2 or more, refer to Exhibit P <br />