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~~ ~~Cc1VLD <br />~_ <br />s, JUN 2 +~ 1991 <br />REGULAR OPERATION (112) Mined Land <br />RECLAMATION PERMIT Reclamation Division <br />APPLICATION FORM <br />The application fora 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 sure to include five (5) si ned copies of the application <br />form five (~) copies of Exhibits A-S, and a check or a application fee described <br />under (3) below. To expedite processing, please provide the information in the format <br />and order described in this form. <br />----- <br />GENERAL OPERATION INFORMATIOPI <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/operator name: xlowA CouNTx <br />1.1 Type of organization (corporation, partnership, etc.): tocAl, cov RNC~ENT <br />2. Operation name (pit, mine or site name): BARNETT PIT <br />2.1 I.R.S. Tax ID No. or Social Security No,: <br />3. Application fee for permitted acreage* I5 permitted acres <br />(550,00 + 515.00/acre, 1st. 50 acres; <br />510.00/acre, 2nd. 50 acres; 55.00/acre, 3rd, 50 acres; <br />51.00/acre, any additional acreage; maximum fee of 52 ,000.00)* <br />Note permitted acreage and application fee and <br />attach a check for this amount when you file. - ~ r application fee <br />4. Substance(s) to be mined (e.g., gravel/gold/borrow): travel <br />5. PJame of owner of surface of affected land+ William A. Barne t s Lucv A. <br />Barnett <br />6. Name of owner of subsurface rights of affected land+ Same <br />7. Type of mining operation: xx Surface _ Underground _ In-situ <br />8. Location Information: the canter of the area where the majority of mining will <br />aca r 1 i es i n: <br />COUNTY: KIOWA <br />PRINCIPAL MERIDIAN (check one): 6th (Colorado) _ 10th (New Mexico) Ute <br />TOWNSHIP (write number and check direction): T 18 _ North x mouth <br />RAPJGE (write number and check direction): R 49 _ East g West <br />SECTION (write number): S 33 <br />QUARTER SECTION (check one): '-AE _ NW x SE SW <br />QUARTER/QUARTER SECTION (check one): x NE NW _ SE _ SW AND <br />GENEA.AL DESCRIPTION: NE1/4NE1T <br />(miles and direction From Eads, 2 1/2 miles South on Road 40, West on <br />from nearest town and Road N 5 1/2 miles, North 3/4 mile. <br />approximate elevation) <br />* If the operator is a unit of state or county government, an application fee is not <br />required, A fraction of an acre mast be counted as one acre for fee calculation. <br />+ If 2 or• more, refer to Exhibit P <br />