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• <br />E:•:HI3IT "A" TO F,?E•^_I?L U.SE pE,;:••^• <br />BET".'iEEP: CLAYTON & SON COUST:~GCT.iO.I CO. AND <br />' THE BOARD OF COUN31' CO'^_!ISSIONF,RS OF <br />GRAND. COCP]TY <br />Depart=._nt of :;atu=al Fe sources <br />P.oca 21.i, 1845 Sherlan St. Telephone: 892-3401 <br />Denvar, Colorado $0?03 <br />Operator' S_ Flan O_ '?Cl?_.'IP.t10R <br />1. 2:a^..2 of operator C.~,9~%:N > ~~.v ~~.,~~Si,JtCP.i/oN ~-~. Phone 7~/. ,3 ~;~, <br />/~ , <br />2. Ac!dress of operator_ „~.~ <,! ~.~/t , ~/~F~SF.~ L%n/~ .sn</r!~ <br />3. Le.ga/~lJjdescription of affected land ~~~T T,oA~?T n/' ~~./</ ~•~../~~ E'i~-i <br />C:/Qoo `/ ~ //~/~ C [ /~ <br />Of= /7FG l.:/~~'E(~/NS.w~/ oF.XlSi[c•N /,~ /O[uNSI1i~ / SOUTH , /SA//~rE <br />7~ ~~Fs- , QUA ~~ ~~~,~- ; y , C~~~a ,~,~ do . • <br />4. (a) Number of acres i-Zo /t~o,o= ~,~ ,(~1~ (b) Initial permit number <br />5. Describe herein the operator's choice of reclamation in accordance with the pro- <br />visions of 92-13-6, Gc~S 19tH, as emended. Details of this plan shall be appropri- <br />ate to the type of reclamation designated. p/J£RA~oRs C~ioicF: oP ~J <br />/ffC~/9 /hA i ioi/ <br />S/19.C.~ QE: fo.¢ roRESi /~.~A.vi i.vy ~ 9~-~~- 6-H c?RSiy73~ ,c~oA [PAivGE <br />C~'~';- /3- b- ~ C/?S i97a ~ oR oN AGR~'Em~;/T ul.Ti, OuJN/E AS /s/vd /.A.va/ <br />/(6'C.~~?~'+q Tion/ auil.4 a/ 1`0~ ~^MFS:r6S ~Y, //d /ir a'xc :.a..9~G ( 9.2_/9-6-/h.) <br />6. Enclose herewith an accurate map of the affected area. The map shall show: <br />(a;~ All pertinent details such as roads and access to the area and reclamation <br />accomplished; <br />(b) Section, toW[t.ship, range and county lines within the scope of the map; <br />(c) Access to the area from the nearest public road; <br />(d) A meridian; <br />(e) A title containing the name of the operator and his address; <br />(f) Scale of the map; <br />(g) Name of engineer or other person who prepared map; <br />(h) The date; <br />(i) The township, range and county of the affected area. <br />7. I hereby certify that the foregoing and attached information is complete and correct <br />as determined from all available records. <br />i <br />Title~,~.~.h. ;~ <br />Date ~ ~i ~,~,.- / % 7 3 <br />Approved by <br />Ti <br />Date <br />Conditiops of approval, if any: <br /> <br />