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. ,. ~~ ~. RECEIVED SPECIAL OPERATION (111) RECLAMATION PERMIT ~~ N 2 8 1991 APPLICATION FORtA Mined sand The application fora Special Operation Reclamation Permit cont~',, ~~gnip~yfl3i~'arts: 1) the application form; 2) Exhibits A-I and, 3) the application-fee. When you submit your application, be sure to include two (2) signed copies of the application form, two (2) copies of Exhibits A-H, and a check for a app ication fee described under (3) below. To expedite processing, please provide the information in the format and order described in this form. m_ g<-p ~ GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, all information described below. 1. Applicant/operator name: rclowA couNTY 1.1 Type of organization (corporation, partnership, etc.): LOCAL GOVERNMENT 2. Operation Name (Pit, mine or site name): FERRIS PIT 2.1 I..R.S. Tax ID No. or Social Security No.: 3. Application Fee for Permitted Acreage* Note affected acreage and application fee and 4. Substance(s) to be mined (e.g., sand/gravel/borrow): 9.8 permitted acres ~~ application fee GRAVEL 5. Name of ~rilner of surface of affected land: ROBERT FERRIS 6. Name of owner of subsurface rights Of affected land: ROBERT FERRIS 7. Type of mining operation: x Surface _ Underground _ In-situ 8. Location Information. The center of the area where the majority of mining will occur lies in: COUNTY: CHEYENNE PRINCIPLE: MERIDIAN (check one): x 6th (Colorado) 1.Oth (New Mexico) Ute TOWNSHIP (write number and check direction): T 16 North xx-South RANGE (write number and check direction): R 51 East xx West SECTION (write number): S 28 / ~ QUARTER :iECTION (check one): Xx~1E NW SE SW QUARTER/()DARTER SECTION (check one): _ NE xx NW _ SE _ SW GENERAL DESCRIPTION: (miles and direction From Haswell, eo East on Hitt av 46. 1 1/7 from nearest town and miles turn North on CR 21 and go 12 1/2 miles approximate elevation) Turn East on Road BB and go 1 mile, Turn North 2 miles, then West 1/2 mile. * If the operator is a governmental subdivision or requires a permit solely for fulfilling a contract with the Colorado Department of Highways, an application fee is not required. A fraction of an acre mist be counted as one acre for fee calculation.