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-; ~ /; . III I II' ll l ll'lll 111 ~~ ~~a'' ~ ~,~° n v p~ OCT 2 3 1990 LIMITED IMPACT OPERATION (110(2)) Mined Land APPLICATION FORM Reciamation Division The Application for a Limited Impact Operation Reclamation Permit contains three ma,or parts: (1) the Application Form, (2) the Application Exhibits A-F, and (3) the application fee. When you submit your Application, be sure to Include two s~i end copies of tfie Application Form, two copies of Exhibits A-F, and a check for the apps ci~i-on fee described under (4) below. To expedite processing, please provide the infornlatlon in the format and order described 1n this form. !'~-~d _13$ ----------------------------------------- - ------------------------ GENERAL OPERATION INFORMATION .Type or print clearly, in the space provided, all information described below. ----L--------------L--L--------..-----2-----2C----3---~ ---C.-L--O--- ~--L--L--E--L-CS-LS6- 1. Applicant/OperdtOr Name: Fremont County Board of County Commissioners 2. Operation Name (Pit, mine or site name): stirrup Pit 3. Application type: Limited Impact Operation (110). 4. Application Fee for Permitted Acreage* 9.61 permitted acres. (S10 x (afferted acres) + 525,00).* Note permitted acreage and application fee and attach a check for this amount when you file. NSA application fee. 5, Substance(s) to be mined (e.g., gold/silver/gravel): craves 6. Owners (s) of Substance to be Mined (check applicable box(s)): _ Private x State _ Federal ` Indian 7. Owner(s) of Record of Affected Land (check applicable box(s)): _ Private x State _ Federal _ Indian 8. Type of Mining Operation (check applicable box(s)): x Surface ` Underground _ In-situ 9. Location Information, The center of the area where the majority of mining will occur ties in: COUNTY: Fremont PRINCIPLE E A c ec one ~ 6th (Colorado) 10th (New Mexico) Ute TOWNSHIP (write number and check direction): T 51 x North South RANGE (write number and check direction): R 12 x East _ West SECTION (write number): S 21 QUARTER SECTION (check one): x ~- _ ~ ~ ~ QUARTER/QUARTER SECTION (check one): _ NE ~ NW _ SE _ SW GENERAL DESCRIPTION: (miles and direction A~rOXlmatelV 30 mil_P_s North of Cnrnnari from nearest town and -_ approximate elevation) 6 8934 feet above sea level * If the operator is a unit of State or county government, an application fee is not required. A fraction of an acre must be counted as one acre for fee calculation.