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t • • • • <br />_~_ <br />3. Nddress and ~hune nw~~oer of P.O. Box 619, Duve Creek, ~ 81329 <br />Local Offices (303) 677-2383 <br />u, riduress and Phone Number of Sane as Atx,vc <br />general Offices <br />7. ila~ne and Prune iVumoer of Person Lewis Bucher, Chairman <br />staff ~•iemoers Snould contact Ik>lc>res Cow~ty Board of G~mnissiuners <br />' o. Owner(s) ur Record or Affected Lana Howard Lee & Elsie Bartley <br />(surface area) (If ~aure inan 2, list below) <br />7. Owner(s) of Suostance to bz i~1ined Same as Item 6 <br />(If more than 2, list below) <br />B. Source of Legal Right-To-Enter Notarized Letter, Exhibit G <br />(Indicate what type of proof is <br />included in EXHIBIT u - lease, <br />deed, notarizes letter, etc.) <br />9. Type of Mine and Substance to be Idined ppen <br />(Specify underyround, open pit, <br />quarry, etc. ~ substance(s) to <br />oe mined) <br />lu. ueneral Location and Elevation 3 Miles S.W. of Dove Creek, ~ <br />(Miles & direction from nearest 6635 M.S.L. <br />town & approximate site elevation) <br />11. county Dolores <br />12. Ncreage of Affected Lands 9.6 Acres <br />(Total surface acreage to be <br />included in permit) <br />13. Npplication Fee (See applicable Waived <br />Rule to detzrnine amount) <br />