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REGULAR (112) PERMIT APPLICATI CN <br /> FORM <br /> -2- <br /> 1 General Location and Elevation 'SOUTH HALF OF THE SOUTHEAST QUARTER, SECTION 1, TOWNSHIP <br /> • (miles and direction from <br /> nearest town and approximate '10 NORTH, RANGE 67 WEST OF THE 6th P.M. , WELD COUNTY, <br /> site elevation) ,COLORADO. ELEVATION = 5565 4 MILES SOUTHEAST OF CARR, CO <br /> ;2. County <br /> WELD COUNTY <br /> Total Surface Acreage to be In- <br /> cluded in Permit. (see Rule 11(2)) <br /> 36.45 ACRES <br /> Total Acreage of Affected Lands <br /> (see Rule 2.11(14)) 36.45 ACRES <br /> 4. Application Fee (see RULE 2 to $350 on - REQUEST GOVERNMENTAL AGENCY WAIVER <br /> determine amount, based on <br /> permitted area) <br /> 5. Present Land Us,? (i .e., agri- GRAVEL BREAK IN PRAIRIE GRASSLAND <br /> cultural, induscrial, etc.) ,EAST 16.5± ACRES PREVIOUSLY MINED) <br /> E. Surrounding Land Uses PRAIRIE GRASSLAND, SOME CULTIVATION <br /> 7. Prol.osed Future Land Use (final <br /> use after reciai:o-3_.=cn) PRAIRIE GRASSLAND <br /> '3. List Mining Oper.Itions Currently NONF <br /> In violation of the Act. (see <br /> 34-32-120) <br /> •' The Lands Herein Do Not Affect TO THE BEST OF MY KNOWLEDGE, NONE OF THE LANDS SO <br /> any of the Lands Described in <br /> IES RIBED ARE INCLUDED IN THIS APPLICATION. <br /> Section 115(4) (C) of the Mined - <br /> Lan; Reclamation Act. (specify <br /> affirmation) <br /> MAPS AND EXHIBITS <br /> -'T each of the five: (5) copies of the application form, the applicant must submit a corrc?rpon•:- <br /> set of the maps and exhibits outlined in RULE 2, as follows: <br /> . EXHIBIT A - Legal Description <br /> 2. EXHIBIT B - Inds: Map <br /> ). EXHIBIT C - Pre-mining and Mining Plan Map(s) of Affected Lands <br /> EXHIBIT D - Mining Plan <br /> • EXHIBIT P - Reciirnation Plan <br /> EXHIBIT F - Reclamation Plan Map <br /> EXH:9IT C - water .information <br /> . E HI3TT S - Wileli.a Information <br /> . EV'(I3IT I - coils information <br /> • I;-I3IT J - vegetation Information <br /> ▪ EXHIBIT K - Climate <br /> . S);Y.I'31T L - Reclamation Costs <br /> • <br /> EXFJ3IT M - Compliance with Local Zoning ) See 34-32-115(4)(c,)& 109(6)!,(.: <br /> . EXHIBIT N - Other Permits or Licenses ) See 34-32-115(4)&(4) (c) <br /> ▪ :':h-IBIT 0 - Source of Legal Right to Enter ) See 34-32-112(2) (d) <br /> EXHIBIT P - Owners of Record of Surface and Subsurface Rights) See 34-32-112(2) (b)&(c) <br /> 3 <br />