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_ <br />LIMITED IMPACT oPtw~tiun C110<2)) <br />RECLAMATION PERMIT <br />APPLICATION FORM <br />CHECK ONE: X New Application (Rule 3.2) Amendment App}ication (Rule 1.8) <br />_ Conversion App 1'i cation (Rule 1.10) <br />The application for a Limited Impact Operation Reclamation Permit contains three mayor <br />parts: (1) the application form; (2) Exhibits A-J; and, (3) the application fee. When <br />you submit your application, be sure to Include one <1> signed original and one <1) copy <br />of the appitcation form, two (2) copies of Exhibits A-J, and a check for the application <br />fee described under (3) below. To expedite processing, please provide the information <br />in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/operator name: GREEN BROS., INC. <br />1.1 Type of organization (corporation, partnership, etc.): CORPORATION <br />2. Operation name (pit, mine or site name): GREEN BROS. GRaUEL PIT <br />2.1 I.R.S. Tax ID No. or Social Security No.: <br />3. Permitted acreage 9.98 permitted acres <br />3.1 Application Fee (New Application Only) 5875.00 appitcation fee <br />4. Substance(s) to be mined Ce.g., gravel/gold/borrow): Sand & Gravel <br />5. Name of owner of surface of affected land: Green Bros „ Inc. <br />6. Name of owner of subsurface rights of affected land: Green Bros,. Inc. <br />7. Type of mining operation: % Surface _ Underground _ In-situ <br />8. Location information. The center of the area where the ma~orlty of mining will <br />occur lies in: <br />COUNTY: Morgan <br />PRINCIPAL MERIDIAN (check one): X 6th (Colorado) 10th (New Mexico) Ute <br />TOWNSHIP (write number and check direction): T t. X North South <br />RANGE (write number and check direction): R ~~ East x West <br />SECTION (write number): S 33 _ <br />QUARTER SECTION (check one>: NE NW ~( SE SW <br />QUARTER/QUARTER SECTION (check one): _ NE _~ NW _ SE _ SW <br />' GENERAL DESCRIPTION: <br />(miles and direction 1 mile East. 1 mile North of Fort Morgan <br />from nearest town and <br />approximate elevation) Elev. 4250 <br />~e <br />~~- ~~ ~ ~ <br />~~ <br />iys~ <br /> <br />