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- 3 - LOCATION INFORMATION: The center o the ar/e~a where the majority of mining will occur: COUNTY: ~C~I.JI\ PRINCIPAL MERIDIAN (check one): ~ 6th (Colorado) 10th (New Mexico) Ute SECTION (write number): S L TOWNSHIP (write number and check direction): T North ~ South RANGE (write number and check direction): R East ~ west QUARTER SECTION (check one): NE NW SE ~ SW QUARTER/QUARTER SECTION (check one): NE NW SE SW GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the ap roximate elevation) w 7 Gi ~~ ~ Primary "future (Poet-minim)" land use (check one): Cropland (CR) Pastureland(PL) General Agriculture (GA) Rangeland(RL) Forestry(FR) Wildlife Habitat(WL) Residential (RS) Recreation (RC) Industrial/Commercial(IC) Developed Water Resources (WR) Solid waste Disposal (WD) Primary "present" land uae (check one _ Cropland(CR) Pastureland(PL) ~ General Agriculture(GA) Rangeland (RL) Forestry (FR) wildlife Habitat (WL) Residential (RS) Recreation (RC) Industrial/Commercial (IC) Developed Water Resources (WR) Mining (MN) If this operation will use designated chemicals, or will result, or presently has acid mine drainage - you cannot use this application form. You must submit a either a 110d or 112d application form for Designated Mining Operations. In either case, you must list any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and whethe/r~ t,~he~ operation will result in or presently has acid mine drainage: I/C~/L1=- ~~-s~~ -/93 .f C~ ~///.O~~J ~S C~~~Q_i~..eJ?-.m .7 Description of Conversion: If you are converting an existing operation, provide a brief narrative describing the proposed change(s). Mane 8 8xhibita: Submit TWO (2) complete, unbound conies of the following application exhibits: 6. 3.1 EXHIBIT A - Legal Description and Location Map 6. 3.2 EXHIBIT B - Site Description 6. 3.3 EXHIBIT C - Mining Plan 6. 3.4 EXHIBIT D - Reclamation Plan 6. 3.5 EXHIBIT E - Maps, to include the location of any recorded easements 6. 3.6 EXHIBIT F - List of Other Permits and Licenses Required 6. 3.7 EXHIBIT G - Source of Legal Right-to-Enter, to include holders of any recorded easements 6. 3.8 EXHIBIT H - Municipalities Within a Two-mile Radius 6. 3.9 EXHIBIT I - Proof of Filing with County Clerk 6. 3.10 EXHIBIT J - Proof of Mailing Notices of Permit Application 6. 1.2 (1)(b) ADDENDUM 1 - Notice Requirements (sample enclosed) 6. 4.19 EXHIBIT 5 - (as required) 6 .5 Geotechnical Stability Exhibit (as required)