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.. ~..', <br />t <br />~~. <br />.~ <br />~~ <br />Adder ress and Phone. Nv~ober of ~ D ~ D x ~~ g , <br />Local Offices <br />- ~F~~~I~S~N ~oLe. ~LN~G <br />_ Address and dhone _Number_ af..~ p~,~ ~ _ <br />'General Offices. ~ - ~ ~~~~~' 'Z`~~.~.~_-~ <br />Name and Phone Number of Person ,Mary E~ Kirkland, Pr-esi.dent •-.- - -. - <br />Staff Members Shouid Contact <br />Owner(s) of Record of Affected Land ~~ `~~ /y`U~`'D~~ <br />(surface area) (If more than 2, list below) <br />Owner(s) of Substance to be Mined MIS <br />(If more than 2. list below) ~ _y__ ~,-f'pa~ <br />Source of Legal Right-To-Enter l~yU~ ~•~Z <br />(Indicate what type of proof is , <br />included in EXHIBIT G - lease, ~ ~"" " <br />deed. notarized letter, etc. ) ~`~-~ <br />Type of Mine and Substance to be Mined Open Pit <br />(Specify underground, open pit, Gravel <br />quarry, etc. b substance(s) to . <br />be mined) <br />General Location and Elevation <br />(Miles b direction from nearest <br />town & approximate site elevation) <br />approximately 6 mi.s/w of Jefferson <br />elevation approximateay 9000 ft. <br />County <br />Park County <br />Acreage of Affected Lands <br />(Total surface acreage to be <br />included in permit} <br />9.9 acres <br />Application Fee (See applicable <br />Rule to determine amount) <br />b3~o~/2,, Do <br />