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• 'I • <br />-2- <br />3. Addre55 and Phone Number of Mitchell Concrete & Caisson Drilling, Inc <br />Local Offices 29975 $arrisville Roaa <br />Calhan, CO 80808 Phone: 591-2342 <br />4. Addre55 and Phone Number of Same as above <br />General Offices <br />5. Name and Phone Number of Person Virgil Mitchell <br />Staff Members Should Contact phone: 591-2342 <br />6. Owner(s) of Record of Affected Ldnd Mitchell Concrete & Caisson <br />(surface area) (If more than 2, list below) Drilling, Inc <br />7. Owner(s) of Substance to be Mined Mitchell Concrete & Caisson <br />(If more than 2, list below) Drilling, Inc <br />8. Source of Legal Right-To-Enter Copy of warranty deed <br />(Indicate what type of proof is <br />included in EXHIBIT G - lease, <br />deed, notarized letter, etc.) <br />9. Type of Mine and Substance to be Mined Type: open Pit <br />(Specify underground, open pit, Substance: Sand, gravel, & rock <br />quarry, etc. & substance(s) to <br />be mined) <br />10. General Location and Elevation Approximately 3.0 miles east of Calhan <br />(Miles & direction from nearest adjacent to Harrisville Road at about <br />town & approximate site elevation) 6750 feet elevation. <br />11. County E1 Paso <br />12. Acreage of Affected Lands 9.5 acres ' <br />(Total surface acreage to be <br />included in permit) <br />13. Application fee (See applicable $125.00 <br />Rule to determine amount) <br />