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<br />REGULAR OPERATION (112)
<br />RECLAMATION PERMIT
<br />APPLICATION FORM ilrvw~c„ :, ,:~ ~ ~ „,, .. -..,
<br />lication for a Regular Operation Reclamation Permit contains three major parts:
<br />application form; (2) Exhibits A-S; and, (31 the application fee. When you
<br />your application, be sure to include five (5) signed copies of the application
<br />flue (5) copies of Exhibits A-S, and a check or a application fee described
<br />• (3) below. To expedite processing, please provide the nf~rmation in the format
<br />order described in this form. .may/ ~s~7aS~~~_ ~, f~J(~_'_-_--,
<br />=zzzaaaazazoaa~=za=~=-•" GENERAL OPERATION INFORMATION ~S!
<br />Type or print clearly, in the space provided, all information described below,
<br />.s zzazzazzazzazazzazaaaaaazzazzaazazzezzazaasaazezzazvazaaaea=azazazssava~evzea=vve-veza
<br />I . Applicant/operator name: S„ ~, ~ ~ ., c hr l'~„~ f. . ! ,, ~ D~~ll•
<br />1.1 Type of organization {corporation, partnership, etc.?: ~r yc,, /1 ,1 ~,•,~ r
<br />2. Operation name (pit, mine or site name): (~~ /r ;, ,,, ,:~ !
<br />2.1 I.R.S. Tax ID No. or Social Security No.:
<br />3. Application fee for permitted acreage* e,-,•; 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 .DO/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. ~'/ ~~-:.:,, application fee
<br />4. Substance(s) to be mined (e.g., gravel/gold/borrow): ., _, ,,~) , „-~,~., I ,...;1 C~6~/e
<br />5. Name of owner of surface of affected land+ c~,~„~.;i,~ ~,.,,,1,
<br />6. Name of owner of subsurface rights of affected land+ ~,,.,,,,,, ;, ,_
<br />_T - -
<br />~. Type of mining operation: ~ Surface Underground _ In-situ
<br />8. Location Information: the center of the area where the majority of mining will
<br />occur lies in:
<br />COUNTY: Sc,,~i,la r i~c
<br />PRINCIPAL MERIDIAN (check one): 6th (Colorado) x 10th (New Mexico) Ute
<br />TOWNSHIP (write number and check direction): T 4r/ ~ North mouth
<br />RANGE (write number and check direction): R ~ ~ East _ West
<br />SECTION (write number): S '
<br />QUARTER SECTION (check one): ~ NE _ Nw SE SW
<br />QUARTER/QUARTER SECTION (check one): NE _ NW _- SE `'y SW
<br />GENERAL DESCRIPTION:
<br />(miles and direction `~ .1 ,,, /P. •;,-, ~ , „-..f •; .,s,,,,~ ~ r C..
<br />from nearest town and
<br />approximate elevation) = L ~ „• ~ ,. ~_/;
<br />rr
<br />* If the operator is a unit of state or county government, an application fee is not
<br />required. A fraction of an acre must be counted as one acre for fee calculation.
<br />+ If 2 or more, refer to Exhibit P
<br />
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