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" ~ <br />dam ~orJ~ n - P, rt ~i,~ , <br />°~~ - - To~.D~~~ <br />6. <br />7. <br />8. <br />9. <br />Cm~t~ieff,ness/ <br />Name of owner of the subsurface riehts of afteMed Iand: ,~ ^~~,'t-ppI~~L "/IV/"Y Imo/ t C t /tip <br />Name of owner of the surface of affected land: p ~~.1C~ -/V ~Yl /lt t-C/C- <br />7.1 Names of the holders of any recorded easements on the affected land: ~~{ e 1) !~a-e <br />t <br />Tvoe of minin¢ oceration: _~ Surface Underground _ In-situ <br />Lceatioe information: The center of the area where the majority of mining will occur: <br />COUNTY: _ P~I~ <br />PRINCIPAL MERIDIAN (check one): _~ 6tlt (Colorado) I Otlt (New Mexico) <br />SECTION (write number): S L 9, 3 Z °' 3 3 <br />TOR'NSI-IIP (write number and check direction): T 9 North <br />RANGE (write n~ber and check direction): R ~ 7 East <br />QUARTER SECTION (check one): NE NW <br />QUARTER/QUARTER SECTION (check one): NE NW <br />~ South <br />c~ west <br />SE <br />Sep ~-_ <br />s~~~~y <br />sw <br />SE Sw <br />GENERAUDESCRIPTION: (Ute number of miles and direction from the neatest town and the approximate elevation): ~-{ m,~ <br />10. Primary future (Foal-mmingl land use (check one <br />Cropland(CR) - Pastureland(PL) <br />Rangeland(RL) __._ Forestry(FR) <br />7~ Residential(RS) ~ Recreation(RC) <br />Developed water Resom~ces(wR) <br />11. Primary present land sae (check one <br />Crophmd(CR) _ Pastureland(PL) <br />Rangeland(RL) _ Foreshy(FR) <br />Residential(RS) _ Recreatiott(RC) <br />_ D.°velop~ ?'afer Resom-ces (wR) <br />General Agriculture(GA) <br />wildlife Habitat(wL) <br />X hhdustriaUCommercisi(IC) <br />_ Solid waste Disposal(wD) <br />_ General Agrictilture(GA) <br />_ wildlife Habitat(wL) <br />_ IndttstriaUCommercial(IC) <br />Mining (~ <br />IZ. If this operation wiQ nse designated chemicals, or wdl result, or presently has acid mine drainage -Yon cannot use this application form. <br />Yon must submit either a 111M or 112d application form for Designated Mining Operations. ht either case, yon must list a~ acidic ar <br />toxic-forming materials, exposed or disturbed as a result of the mining operation, and whedter the operation will tesnlt m or presently <br />has acid mine drainage: <br />13. Description of Amendment or Co version: <br />If you are amending or converting an existing operation, provide a brief narrative describing dte proposed change(s): <br />