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i <br />1 <br />1 <br />1 <br />1 <br />1 <br />1 <br />1 <br />1 <br />9. Source of Legal Right-to-Enter <br />(indicate what type of proof is <br />included in EXHIBIT 0) See <br />Rule 34-32-112(2)(d) <br />-2- <br />Notarized Statement <br />10. Type of Mine and Substance to ~ .Sand and gravel <br />be Mined (specify underground, <br />open pit, quarry, etc. and <br />substance(s) to be mined <br />ll. General Location and Elevation I Approximately one mile North and one-half <br /> (miles and direction from ~ m;le wPGt ~f r;E~ f n..r} r.,ii;..~_ti.,~,..a....:,... <br /> nearest town and approximate <br /> Site elevation Elevation 4990' <br />12. County Larimer <br />13a Total Surface Acrea a to be <br />Included in Permit Rule 1.1(2)) 11 acres <br />13b Total Acreage of Affected Lands <br />(Rule 2.11(14)) 11 acres <br />14. Application fee (see Rule 2 to $215.00 <br /> determine amount, based on <br />permitted area) <br />15. Present Land Use (i.e., <br />agricultural, industrial, etc.) Partially <br />extraction completed Open Pit for <br />of gravel and road base <br />16. Surrounding Land Uses Rangeland/Industrial <br />17. Proposed Future Land USe (final <br />use after reclamation) Pond with vegetated shoreline <br />18. List Mining Operations Currently NONE <br /> In Uiolation of the Act. (See <br /> 34-32-120) . <br />19. The Lands Herein Do Not Affect Affirmativ e <br /> any of the Lands Described in <br /> Section 115(4)(f) of the Mined <br /> land Reclamation Act. (specify <br /> affirmation) <br />