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ri. Name of owner of the subsurface riehts n(aRected land: ~ It-~t L <br />~. Name of owner of the surface of affected land: _Sa,~n 1? '~" ~/f+1=~ z-L )/>`~=~ ~-= <br />7.1 Names of the holders of any recorded easements on the affected land: <br />8. Tvoe of minino operation: / Surface __ Underground __ In-situ <br />9. Location information: The center of the area where the majority of mini ng will occur: <br />ColJT7TY: ~-a2 n1zR <br />PRINCIPAL MERIDIAN (check one): ~ 6th (Colorado) 10th (New Mexico) Ute <br />SECTION (write number): S <br />TOWNSHIP (write number and check d'vettion): T _ North _ South <br />RANGE (write number and check direction): R _ East West <br />QUARTER SECTION (check one): _ NE ^ NW _ SE _ SW <br />QUARTER/QUARTERSEC71ON (check one): _ NE _ NW _ SE _ SW <br />GENERAL DESCRIPTION: (the number of miles and direction Gom the nearest town and the approximate elevation): ~ - 5' <br />10. Primary future (Post-minieY) land use (check onel: <br />_ Cropland(CR) _ Pazturetand(PL) _ General Agricuhure(GA) <br />V Rangeland(RL) _ Forestry(FR) _ WildlifeHabitat(Wl-) <br />_ Resideotial(RS) _ Recreation(RC) _ IndustriaUCommercial(1C) <br />- Developed WaterResources(WR) _ Solid WazteDisposal(WD) <br />11. Primary present land use (check onel: <br />Cropland(CR) , Pastureland(PL) _ General Agriculture(GA) <br />/Rangeland(RL) _ Forestry(FR) _ WildlifeHabitat(WL) <br />_ Residential(RS) _ Recreation(RC) _- IndustriaUCommercial(iC) <br />Developed WaterResources(WR) _ Mining(MN) <br />12. If this operation will use designated chemit~ls, or will result, or presently haz acid mine drainage -you cannot use this application form. Yov must <br />submit either a } 30d or 1 ]2d application form for Designated Mining Operations. In either case, you must list any acidic or toxic-forming <br />mazerials, exposed or disturbed as a result ofthe mining operation, and whether the operation will result in or presently has acid mine drainage: <br />13, Description of ,amendment or Conversion: <br />I f you are amending or converting an existing operation, provide a brief narrative describine the proposed change(s): <br />N ~r <br />