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.! . , <br />! ~ <br />-z- <br />3. Address and Phone wwaoer of 117 White Pine Drive, Alamosa, CO 81101 <br />Local Offices (303) 589-5105 <br />4. Adores and Phone Number of <br />General Offices same <br />5. Name and Phone Plumper of Person <br />Staff i~leinoers Should Contact Mr. Leroy Relt <br />6. Owner(s) of Record of Affected Lana Henry Southwa Jr. <br />(surface area) (If inure than 2, list below) d/b/a So. Way Co. <br /> a sole propri torship <br /> <br />7. U~+ner(s) of Substance to be dined Henry Southwa Jr. <br />(If more than 2, list belo•.+) d/b/a So. Wav Co. <br /> a enlo nrnnri tnrchin <br />d. Source of Legal Riynt-To-Enter <br />(Indicate wnat type of proof is <br />included in EXHIBIT G - lease, deed <br />deed, notarizes letter, etc.) <br />U. Type of Mine and Substance to be tuned <br />(Specify underyrouna, open pit, <br />quarry, ecc. ~ substance(s) to open pit, sand and ravel <br />oe mined) <br />lu. General location and Elevation approximately 1~ mi es northeast <br />(Milos ~ direction from nearest of Del Norte, Color do. <br />town & approximate site elevation) Elevation approxima elv 7,8.50 feet <br />11. County Rio Grande <br />12. Acreage of Affected Lands <br />(Total surface acreage to be <br />included in permit) 8.88 acres <br />13. Application Fee (See applicaule <br />Rule to determine amount) 5115.00 <br />