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<br /> <br />,~ , . ~y4, <br />LIMITED IMPACT OPERATION (110(2)) IVIIn6d Land <br />RECLAMATION PERMIT eclam^+~~~ ^`'°.,l~n <br />APPLICATION FORM <br />CHECK ONE: xx New A itcation (Rule 3.2) Amend nt App}ication (Rule 1.8) <br />Converse n Application (Rule 1.10) <br />The application for a Limited mpact Operation Reclamatto Permit contains three major <br />parts: (1> the application for (2) Exhibits A-J; and, (3) the application fee. When <br />you submit your application, be ure to include one (1) si ned original and one (1) copy <br />of the application form, two <2) opies of Exhibits A- and a chec for the application <br />fee described under (3) below. To expedite processin please provide the information <br />in the format and order described 1 this. form. f`']~~2-J~(_J <br />a aaaaaaaaaaavaaavvavaaavavaaavaaaava vavvavaaaaaav aaaaavc3v va===a asaaavaaaavaaaaaaaa= <br />GENERAL PERATION INF RMATION <br />Type or print clearly, in the spa provided, ale Information escribed below. <br />1. Applicant/operator name: CITY of r NT VISTA <br />1.1 Type of organization (Corporation partnership, etc.): _ <br />2. Operation name (pit, mine or site nam LAGOON PIT <br />2.1 I.R.S. lax ID No. or Social Se urity N 8a-6ooo6io <br />3. Permitted acreage <br />3.1 Application Fee (New Apple ation Only) <br />4. Substance(s) to be mined (e.g. gravel/gold/borrow <br />5. Name of owner of surface of fected land: cITY F MoN <br />6. Name of owner of subsurface rights of affected land: cI <br />7. Type of mining operation: x Surface _ Underground <br />8. Location Information. a center of the area where the ma <br />occur lies 1n: <br />COUNTY: RIO GRANDE <br />PRINCIPAL MERIDIAN ( eck one): 6th (Colorado) ~ 1 <br />TOWNSHIP (write num rand check direction): T 39 <br />RANGE (write number and check direction): R x <br />SECTION (write num er): S 32 <br />QUARTER SECTION ( eck one): x NE <br />I7 permitted acres <br />.0 application fee <br />VE <br />V <br />In-si <br />~orit <br /> <br />QUARTER/QUARTER S CTION (check one): _ NE _ <br />GENERAL DESCRIPT ON: <br /><miles and dire ti0n ONE MILE NOR'I'IlEAST OF MONTE VIS <br />from nearest to n and <br />approximate el vation) 7666' <br />of mining will <br />Mexico) Ute <br />rth _ South <br />st West <br />SE SW <br />_ SE x SW <br />