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Form 3604-l b FORM APPROVED <br /> (August 2013) UNITED STATES OMB NO 10044MI <br /> DEPARTMENT OF THE INTERIOR Expires August 31,2016 <br /> MINERAL MATERIAL BUREAU OF LAND <br /> FREE USE PERMIT MANAGEMENT <br /> FIELD OFFICE <br /> Permit(Case)Serial NumberCOC-053397 Expiration Date 03/12/2028 <br /> Permittee Name and Address* <br /> Grand County Road and Bridge P.O. Box 9 Granby,CO 80446 <br /> Legal land description of authorized permit area: <br /> Inspiration Point Pit <br /> Meridian I Township Range I Section I Subdivision Acres <br /> 6th is 81 W 17 W/2,NW/4 29.5 <br /> This permit is issued under the Act of July 31, 1947, as amended, and 43 U.S.C. 2 and 1201. Free use permits are issued subject to the <br /> requirements of 43 CFT Part 3600 now or hereafter in force. <br /> This permit is hereby issued for the materials applied for but may be canceled if it appears that this this permit was issued erroneously or the <br /> terms or conditions contained herein are not observed. <br /> The permit is subject to the following standard stipulations: <br /> Any use of the surface of the lands involved in this permit must not interfere with any mining claim subject to the provisions of <br /> Section 4 of the Act of July 23,2955(30 U.S.C.612): <br /> The permittee must allow BLM access for inspections as required by 43 CFT 3601,51 <br /> The permittee must clean up all work areas and must remove or dispose of all refuse resulting from the permittee's operations, <br /> and equipment, personal property, and improvements must be removed within ninety (90) days after the permit expiration date <br /> as required by 43 CFR 3601.52 <br /> An annual report indicating the amount(cubic yards or tons)of material removed must be filed with the BLM Field Office on the <br /> anniversary date of the permit,and within thirty(30)days after permit expiration. <br /> The permit is also subject to the following SPECIAL CONDITIONS: <br /> Authorized purpose: <br /> Pit run sand and gravel for road material. <br /> Authorized term Authorized quantity,in-place <br /> 10 vears 0 months 0 da}s 200,000 cubic yards or tons <br /> Check all that apply: <br /> ® Permittee Mining and Reclamation plan is required per 43 CFT 3601,40-44 <br /> ® Permittee is responsible for reclamation of permit area <br /> ❑ Financial Guarantee is required per 43 CFR 3602.14 <br /> ❑ Removal area is within Community Pit—Common Use Area-Serial No. <br /> ❑ Permittee will perform reclamation in Community Pit--Common Use Area in lieu of reclamation fee <br /> ❑ Permittee must follow/comply with BLM mining and reclamation plan <br /> ❑ Permittee will pay a reclamation fee for Community Pit—Common Use Area as identified below: <br /> Quantity <br /> Reclamation Fee <br /> (select applicable in-place units' TOTAL Reclamation <br /> Ty <br /> ne of Material (select applicable in-glace units) EU <br /> ❑� cu.yds. ❑! S nar cu.yds. S Der ton L51 <br /> Sand and Gravel, S&G 200000.00 0.00 $0.00 <br /> ❑/ BLM will check this box it there are additional stipulations attached to this permit. <br /> (Continued on page 2) (Form 3604-1b,page 1) <br />