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1~PV3)t UNITED STATES ~~~~IVI=~ ~~e <br />DEPARTMENT OF THE INTERIOR permit Nnmber <br />BUREAU OFt.AND MANAGEMENT ~(J(y ~ ~ 1994 COC <br />' FREE USE APPLICATION ANO PERMQ Fipiratioa Due <br />VEGETATNE OR MINERAL MATERIAEureau of Lantl Manap Dect <br />Drstna <br />APPLICATION r Mnn tr.. <br />Name of aPP~t .Address (urdrrde rip code) <br />Dolo=es County P.O. Box 608, Dove Creek, CO 81324 <br />Kind of material GL'dVel ~ Estimated quantity 25, 000 yards <br />Give legal la°d detaiptio° <br />T09YNSHiP RANGE SECf10N SUBD1YL910N <br />42N 16W 25 S}SE}HW}SE}, N}NE}SW}SE}, S1i}NE}SN}SE}, <br />W}NW}SE}SE} <br />slue or Colorado Con°ty °f Dolores - <br />Materials ate b be ased for Road Material. <br />[ HEREBY AGRFPTO COMPLY WfCH Ike ipeda! Cooditjans u iU (o[tk below, I t.,FJ1:TIFY Tlut the: (a) materials to be removed ate to be use for the purpose noted <br />above; (b) none o(tke ma4tials temavcd are b be wid arbarteted; (e) rcmovd of materials can begin ody upon receipt o[an approved copy of rhir permit; and, (d) the <br />authorfred oGoet is b be notifiod upon wmpbxian of removal .. <br />I CERTIFY Tku I am a dtina of We United States, and of the age of majority in the State in which I rmide. <br />I FURTHER CERTIFY Thu We suremeats made by me io ibis applitztioo ate true, eompi<te, and cortect to the bet of my knowledge and belid and arc made in good <br />faith. <br />8-29-94 <br />(Dau) <br />TWe IgUS.CSeaiea Io01, matertaa®efaran~pasoataowioglyaad ar61luDYto malxm aayd<partmearor ageoeyof the Uated States anyfahgfiaidam, or fraudulent rtuetaeau or <br />rcprcematlaos n tti soy maeta.~ithin iu jasidcttaa. ~ . <br />-PEHMR <br />• sPECfaI.coNOmoNs <br />This permit is hmeby issued for the m.r^^•t~ applied (o; bat maybe ca°crJ°d if it appurt lhat this permit wu issu<d ertoncously or ike rums or conditions wotuncd <br />heron arc na observed- It shall be rbjat to ti- teBow~ ryr.31 cuadtionz <br />ATTACHED <br />Coaswatioa praeticaneur be anied out u provided bya3 CFR SSI I.1-1(b)..2-7(e), <br />and 3-); <br />FquipmwC P~~ ProP~Y. and improvernenu mart be removed within ninety(9o) <br />days after ezpiruion dare U CFR SS 113.5}, <br />Any roc o[ the turfa« of rite lands inrolrod in Wit permit shah be ruck u nor to <br />iatafuewiW auyniiningcLim subjcG to the prariaou of Sonion ~ o[ We Am ofJWy <br />y, 1935 (30 US.C 613); <br />The permi[ue shall clean up all rock ucas and shall rtmose or dispou of ill rtfus< <br />resulting from the permitta'a opentiom; <br />Thb permit u issued uod<r We Ace of July l 1, 19a7, u amended, and aJ U.S.C. and <br />l1Al, sad uad<r the [tee use pririkge o[ We Aa o(May la, 1898 (Alaska only). <br />A° annual rtport indiutiog the amount (cu yds. or tom) of material rtmoveJ mutt be <br />filed with We District Olficego the anniversary dare of the permit,err Within thirty (30) <br />days a~r<r permit eap'uation (Atoka Daly). <br />APPLICANT ~ri~};~3~ AREA MAfJACE4 <br />