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1 <br />P+IAR 2 U 1987 <br />' MINED LAND REGULAR (112) PERMIT <br />RECLAMATION DIVISION APPLICATION FORM <br />This form contains two major parts: (1) General Operation Information and (2) Exhibits <br />A-P. When you submit your application, be sure to include four ~si_ named copies of the <br />General Operation Information, four copies of Exhibits A-P, and a c e k for the <br />application fee described under (4) below. To expedite processing, please provide the <br />' information in the format and order described in this form.~_~~_t~-~-~Y/~a7 ~/7~yc~ <br />GENERAL OPERATION INFORMATION <br />' Type or print clearly, in the space provided, all information described below. <br />-------- ------- - ----- - ------ <br />1. Applicant/Operator Name: Ready Mixed Concrete Company <br />' 2. Operation Name (Pit, mine or site name): Bromley Lakes <br /> 3. Application type: Regular (112) Permit Operation. <br />' * <br /> 4. Application Fee ($10 x (affected acres) + 525.00). 3gg affected acres. <br /> Note affected acreage and application fee and <br />' attach a check for this amount when you file. $t,789.0o application fee. <br /> 5. Substance(s) to be mined (e. g., gold/silver/gravel): sang and Gravel <br />' 6. Owners(s) of Substance to be Mined <br /> (check applicable box(s)): xf& Private ^ State ^ Federal ^ Indian <br />t 7. Owner(s) of Record of Affected Land <br /> (check applicable box(s)): ~ Private ^ State ^ Federal ^ Indian <br /> 8. Type of Mining Operation <br />t (check applicable box(s)): ti3 Surface ^ Underground ^ In-situ <br /> 9. Location Information. The center of the area where the majority of mining will <br />' occur lies in: <br /> COUNTY: <br />PRINCIPLE MER D AN c ec: one 6th (Colorado) A®~FKXNAf~KAI~~i~X ~llkl <br />' TOWNSHIP (write number and check direc on i ^ North ;^ South <br /> RANGE (write number and check direction): R 67 ^ East ~ West <br /> SECTION (write number): S t3 <br />' QUARTER SECTION (check one): ^-Al^ i3 NW ^ SE ^ SW(entire <br /> QUARTER/QUARTER SECTION (check one): ^ NE ^ NW ^ SE ^ SWNW 4) <br /> GENERAL DESCRIPTION: <br /> (miles and direction iii mile we st. oe 6rienton. co <br /> from nearest town and <br /> approximate elevation) 4970 <br />' * If the operator is a unit of State or county government, an application fee is not <br /> required. A fraction of an acre must be counted as one acre for fee calculation. <br /> <br />1 <br />