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~ ,~ • III IIIIIIIIIIIII III ~~ ~ ~,y~„~ ~ ~~ / REGULAR OPERATION (112 ) JUN 2 8 199 i RECLAMATION PERMIT APPLICATION FORM Mined Land Reclamation Division The application fora Regular Operation Reclamation Permit contains three major parts: (1) the application form; (2) Exhibits A-S; and, (3) the application fee. When you submit your application, be sure to include five (5) si ned copies of the application form five (5) copies of Exhibits A-S, and a check or a application fee described under (3) below. To expedite processing, please provide the information in the format and order described in this form. __________________________________________________________________________~?=~1===- ~~-_ GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, all information described below. ----------- ------------------- ------ ----------- 1 1.1 Type of organization (corporation, partnership, etc.): Local c vernmenc 2. Operation name (pit, mine or site name): BARNES PIT 2.1 I.R.S. Tax ID No. or Social Secv rity No.: 3. Application fee for permitted acreage* 48.5 permitted acres (b50,00 + E15.00/acre, 1st. 50 acres; 510.00/acre, 2nd. 50 acres; E5.00/acre, 3rd. 50 acres; 51.00/ac:re, any additional acreage; maximum fee of 52 ,000.00)* Note permitted acreage and application fee and attach a check for this amount when you file. - ~ - application fee 4. Substanc:e(s) to be mined (e.g., gravel/gold/borrow): travel 5. Name of owner of surface of affected land+ Flovd Barnes 6. Name of owner of subsurface rights of affected land+ Flovd Barnes 7. Type of mining operation: x Surface _ Underground _ In-situ 8. Location Information: the center of the area where the majority of mining will scar lies in: COUNTY: KIOwA PRINC]:PAL MERIDIAN (check one): xx 6th (Colorado) TOWNSJ•IIP (write number and check direction): T 19 RANGE (write number and check direction): R 42 SECTION (write number): 5 34 QUARTER SECTION (check one): -NE QUARTER/QUARTER SECTION (check one): _ NE GENERP,L DESCRIPTION: (miles and direction from nearest town and approximate elevation) Applicant/operator name: KIOWA COUNTY 10th (New Mexico) Ute North ~'3outh i East ~ West x NW SE SW X NW - SE X SW * If the operator is a unit of state or county government, an application fee is not required.. A fraction of an acre must be counted as one acre for fee calculation. + If 2 or more, refer to Exhibit P