2016-07-29_PERMIT FILE - M1991073

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` . Ili IIIIilillllliill '��c.,�� t,,� • goo LIMITED IMPACT OPERATION (110(2)) A 16 1992 RECLAMATION PERMIT Fie�la 1JnLd Land APPLICATION FORM The application for a Limited Impact Operation Reclamation Permit contains three major parts: (1 ) the application form; (2) Exhibits A-J; and, (3) the application fee. When you submit your application, be sure to include two (2) signed originals of the application form, two (2) copies of Exhibits A-J , and a c e -for the application fee described under (3) below. To expedite processing, please provide th information in the format and order described in this form, _�� GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, all information described below, 1 . Applicant/operator name: xzowA couNTy 73 1 .1 Type of organization (corporation, partnership, etc.): Local Government 2. Operation name (pit, mine or site name): FERRIS PIT 2.1 I.R.S. Tax ID No. or Social Security No.: low- 3. Application fee for permitted acreage* 9,8 permitted acres ($25. .00 + 10/acre)* Note permitted acreage and application fee and attach a check for this amount when you file. application fee 4. Substance(s) to be mined (e.g., gravel/gold/borrow): Crave _„ S. Name of owner of surface of affected land: Robert-Ferris 6. Name of owner of subsurface rights of affected land: Robert Ferris 7. Type of mining operation: xx Surface w Underground In-situ S. Location information. The center of the area where the majority of mining will occur lies in: COUNTY: CHExExNE PRINCIPAL MERIDIAN (check one): xx 6th (Colorado) 10th (New Mexico) Ute TOWNSHIP (write number and check direction): T .1� North -3outh RANGE (write number and check direction): R _.�1_. East — Best SECTION (write number): S — QUARTER SECTION (check one): NW SE SW QUARTER/QUARTER SECTION (check one): NE 2cx NW '—' SE ` SW GENERAL DESCRIPTION: (miles and direction From 8aswell, go East on Highway 20, L III miles from nearest town and turn North on C.R. 21 and go 12 1/2 miles, Turn approximate elevation) East on Road BB and go ]miler,, Uln North 2_ i e_ . then West 112 mile. * A fraction of an acre oust be counted as one acre for fee calculation. If the operator is a unit of state or county government, an application fee is not required.