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i, <br />~, <br />-Z- <br />3. Address and Phone NuinDOr of P. o. Box 1528 Buena Vista, Colorado 81211 <br /> Local Offices (303) 395-6660 <br />4. Address and Phone tJumber of 1001 S. Hie~way 78-7 Wylie, Texas 75098 <br /> General Offices (214) 442-5093 <br />5. Naine and Phone Number of Person Eddie R. McCrary, Owner <br /> Stdff hlembers Should (.OntdCt (303) 395-6660 or (214) 442-5093 <br />6. Owner(s) of Record of Affected Land Richard A. and Gloria A. zeif <br /> (surface area) (If more than 2, ]ist below) <br />7. Owner(s) of Substance to be Mined Richard A. and Gloria A. Zeif <br /> (If more than Z, list below) <br />z3. Source of Legal Right-7o-Enter <br /> (Indicate what type of proof is Notari zed letter <br />• included in E%HIBIT G - lease, <br /> deed, notarized letter, etc.) <br />9. Type of Mine and Substance to be Mined <br /> (Specify underyround, open pit, <br /> <br />quarry, eic. & suostance(s) to Open pit; gold anti associated minerals <br /> oe mined) <br />lU. General Location and Elevation <br />(Miles & direction from nearest <br />town & approximate site elevation) <br />One mile west of Fairplay, Colorado <br />Approximate elevation 10,060 feet <br />11. County <br />12. Acreage of Affected Lands <br />(Total surface acreage to be <br />included in permit) <br />13. Application Fee (See applicable <br />Rule to determine amount) <br />Park <br />9.9 acres <br />$125.00 <br />~, <br />