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III IIIIV{IIIIIIIIII• il)1 i19 19~ <br />REGUIh.. ,,..,.,, ss~„ , ~ , :, Mined Land <br />RECLAMATION PERMIT <br />APPLICATION FORM Re(:lAm~+}inr n'".:~;^n <br />The application for a Regular Operation Reclamation Permit contains three major parts: <br />(1) the application form; (2) Exhibits A-S; and,"(3) the application fee. When you <br />submit your application, be su~~e to include five (5) signed copies of the application <br />form five (5> copies of Exhil~°~ts A-S, and a check for the application fee described <br />under Section (14> on Page 3. To expedite processing, please provide the information in <br />the for.?:dt and order described in this form. ' <br />macc.c.ccc.c..cc.ccccccvac_cca ccsve3m cacssxcaaYSacacasvsarvavvvsavsvsassaasaacamsacacc= <br />GENERAL OPERATION INFORI4ATION <br />Type or print clearly, in the space provided, all information described below. <br />aacc=c..ccc..ee c..cce.=z.ecac::c ece=va.cazaaazve{Vass::saaaamszasrasaaaaaaamcvvasaazaaa.=_ <br />1. Applicant operator name: Demetrio and Olive Valdez _ <br /> 1.1 Type of organizatior (corporation, partnership, etc.>: Husband and wife <br /> { as joint enan s <br />2. Operation name (pit, mine o r Site name): Va ldez Gravel Mine <br /> 2.1 I.R.S. Tax ID No. or Social Security o.: Applied for <br />3. Permitted Acres: 30 Permitted acre: <br /> Please indicate acrea ge to the neares tenth (10th) acre. <br /> 3.1 Application fee (sea Section 14>; ~ $1,875.00 Application fee <br />4. Substance(s) to be mined :e .g., gravel/gold' borrow>: Sand and gravel <br />5. Name of owner of surface of affected land: Deme~trio and Olive Valdez <br />6. Name of owner of subsurface rights of affected land: Same as above _ <br /> If 2 or more owners, refer to Exhibit P. <br />7. Type of mining operation.: ~ x Surface ,_ Undergroun~ <br />8. Location Information: thu center of the area whe,•e the majority of mining will <br /> occur lies in: <br />COUNTY: Conejos <br />PRINCIPAL MERIDIAN (check. one): 6th (Colorado) x 10th (New Mexico) Ute <br />TOWNSHIP (write number and check direction): T 3~ _x North _ South <br />RANGE (write number and check direction): R ~- x East _ West <br />SECTION (write number): 5 ~- <br />QUARTER SECTION (check cane): _ NE x NW _ SE _ SW <br />QUARTER/QUARTER SECTION (Check one): _ NE ,_ NW _ SE _ SW <br />GENERAL DESCRIPTION: <br />(miles and direction approximately 3 miles from Antonito,CO <br />from nearest town and <br />approximate elevation) ap roximately 7,000 ft. elevation <br />Z <br />