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<br />-2- <br />' 3. Address and Phone Number of <br />Local Offices <br />P. 0. Box 187, Craig CO 81626, 824-4401 <br />4. Address and Phone Number of <br />General Offices <br />Same <br />5. Name and Phone Number of Person <br />Staff Members Should Contact <br />Bruce klumphries <br />6. Owner(s) of Record of Affected Land <br />(surface area) (If more than 2, list below) <br />State of Colorado <br />7. Owner(s) of Substance to be Mined <br />(If more than 2, list below) <br />State of Colorado <br />8. Source of Legal Right-To-Enter <br />(Indicate what type of proof is <br />included in EXHIBIT G - lease, <br />deed, notarized letter, etc.) <br />State Permit No. 186-5 <br />9. Type of Mine and Substance to be Mined <br />(Specify underground, open pit, <br />quarry, etc. & substance(s) to <br />be mined) <br />open pit for sand and gravel <br />10. General Location and Elevation <br />(Miles & direction from nearest <br />town & approximate site elevation) <br />5 mi. south of Craig - elevation 5,000 ft. <br />11. County <br />Moffat <br />12. Acreage of Affected Lands <br />(Total surface acreage to be <br />included in permit) <br />9,99 acres <br />13. Application Fee (See applicable <br />Rule to determine amount) <br />125.00 <br />