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I <br />• <br />i <br />3. Address and Phone Number of <br />Local Offices <br />4. Address and Phone Number of <br />General Offices Same <br />i <br />5. Name and Phone IVUmoer of Person Ira Paulin or John Carder+ <br />Staff ~~lembers Snould Contact Tele: 303-336-9416 ,3 ~ - =r T7 <br />- - <br />b. Owner(s) of ~tecord of Affected Land <br />(surface area) (If more than 'L, list below) <br />-2- <br />P.0 Box 721, Lamar, CO 811052 <br />Te1e: 303-336-9416 <br />Harold L. Hoffman & Bonnie J. Earl <br />7. Owner(s) of Substance to be Mined <br />(If more than 2, list below) <br />Harold L. Hoffman & <br />ie J. Earl <br />~l. Source of Legal Right-To-Enter <br />(Indicate what type of proof is <br />included in EXHI3IT G - lease, <br />deed, notarized letter, etc.) <br />Lease <br />9. Type of Mine and Substance to oe Mined ~ <br />(Specify underyround, open pit, Open Pit Sand & Gravel 'i <br />quarry, etc. & suostance(s) to <br />oe mined) <br />lU. General Location and Elevation 3 miles south & 1 mile est of <br />(Miles & direction from nearest McClave, Colorado @ 750' <br />town & approximate site elevation) <br />11. County Bent <br />I <br />1Z. Acreage of Affected Lands <br />(Total surface acreage to be <br />included in permit) <br />13. Application Fee (See applicable <br />Rule to determine amount) <br />9.9+ acres <br />$125.00 <br />