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EGQLAR OPERATION (112) DCr`C~~~F~ <br />Rfic'r.aecamrON PERMIT <br />APPLICAITON FORrs ~AIV ~ 6 199E <br />CI~CK ONE: ~ New Application (Rule 1.4.5) NU ision o~Mifle a se BOOajp9YRnle 1.10) <br />Conversion Application (Rule 1.11) <br />Permit No_ M- - (provide for amendments and caaversioas of existing <br />permits) <br />The application for a Regular Operation Reclamation Permit contains three major parts: (1) <br />the application form; (2) 8xhibits A-S and Geotecbaical Stability fixhibit; and, (3) the <br />application fee. idben you submit your application, be sure to include one (1) signed and <br />notarized original and four l4) tropics of the application form, five (5) copies of Exhibits <br />A-R and nay required sections of Exhibit Sand the Geotechaical Stability Exhibit, and a <br />dxeck for the application fee described under Section (16) an Page 3. ~chibits should not <br />be bound oz in a 3-ring binder; maps should be folded to 8 1/2" % 11• or 8 1/2* Z 14" size. <br />Tb expedite processing, please provide the information in the format and order described <br />in this form. - --------------------- ~ _~~= o ~ ~~______ <br />-------------------- -- ---- - <br />rslvconr. OPERATION INFORdATION <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/operator or cam <br />aay name (name to be used on permit): <br />p <br /> St ~ // <br />/J <br />,.InG/lP ~c n~5 Y.O,. [/ n~ ~~~~./f ~,xnn F.-lin/- <br /> 1.1 Type of organization (corporation, partnership, etc.): Gn./,•r.,..,~oi- <br /> 1.2 I.R.S. ~~ No. or Social Security Number: 4fl - r7v 09 3 <br />2_ Operation. acme (pit, mine or site name): ~ o/P iN.xn F'.~~' <br />3. Permitted acreage (new or existing site) y~ permitted acres <br /> 3.1 Change in acreage (+ or -) -o- acres <br /> 3.2 Total acreage is Permit area c1C acres <br />4. Fee6: <br /> 4.1 New Application x 51.875.00 application fee <br /> 4.2 New Quarry Application 52.325.00 quarry applicatien <br /> 4.3 Milling Application (Non-DMO) 53.100.00 milling applicaticn <br /> 4.4 Amendment Fee 51.550.00 amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) 51.500.00 conversion fee <br />S. Primary CO®Od].tle (6) t0 be mlIIed: -Grt..:~ Crn.~e( efh(./e Sb.,~l ~_.('r.,. <br />6 . Name of owner of surface of affected land: S n ./ a ... / , i'~., ,, +~, <br />7 . Name of owner of subsurface rights of affected land: Ste. e.. R, ~ . ~ ~ .... ~ <br /> If 2 or more owners, refer to Exhibit o_ <br />8. Type of m;,,;,,g operation: _~SUrface _ IIndergrrnmd Ia-situ <br />9. Location Information: the center of the area where the majority of. mining will <br />occur lies in: <br />COIINTY: 5~,. .r ~. r,. ~ . <br />_ <br />PRSNCIPAL NfiRT_DIAN (c^heck one): _ 6th (Colorado) !~lOth (Nev M°rico) _ IIte <br />SfiCTZON (write number) : S _LL <br />TOWRSffiP (write number and check direction) : T _4Y x Forth _ South <br />RANGE (write number and cher3c direction): R ~ ~ East _ Tizest <br />QOARTfiR SECTION (check one): ~ NE _ NW _ SE Sw <br />QD~i1RTII2/QOART'ER SECTION (check one) . Nfi Nw SE jL Sw <br />GfiFERAL DESCRIPTION (miles and direction from nearest town and approximate <br />elevation) c D ~ /v, /~ s .f~ ~F Sa~.. n,~. c~/e.,o,/n r'/.~ ~ i Yo Fr. <br />