PERMFILE54875

• Permit No: M1986074
• IBM Index Class Name: Permit File
• Section_Exhibit Name: EXHIBIT D WILDLIFE WATER RESOURCES VEGETATION AND SOILS INFORMATION
• Media Type: D
• Archive: No

~• MINED LAND WILDLIFE QUESTIONAIRE
for limited impact and select regular mine applications
1. Name of Company/Ptine: Don Kehn Construction, Inc./Dollerschell Pit
2. Name/Address/Phone of Contact Person: Doug Kehn, 6322 S. College Ave,
Ft. Collins, CO 80525 [phone]
Logan Count, West ~ of section 21, owns ip ort ange
3. Location of ;tine: West of the 6th P.M.
(County, Township, Range, Section to nearest quarter quarter; Exhibit A-:•tLR appl.)
4. Nearest Town/General Location: Sterling, CO County Road 29 & 32
5. Land Ownership (Circle) 1. Private 2. BLPS 3. USFS 4. Other
6. Present Land Use: Gravel Pit
7. Proposed Final Land Use: Patureland, Wildlife Refuge
8. Type of Operation: 1. Surface 2. Underground
9. Minerals being mined: Sand and eravel
10. Number and Description of Surface Acres Disturbed by Mining/not including roads
(Exhibit D-MLR): 9.9 acres i
11. Miles of roads to be constructed: None
12. Life of Mine (years):
13. Description of Operation and Reclamation -- Additional sheets may be attached
(Exhibits B b E-MLR)
14. Please enclose Maps of Project Operation, Disturbance Areas and Reclamation (Exhibit
C.) This will expedite processing. Your cooperation is appreciated.
15, Prepared by: ,o, Date: ~ zA
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