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<br /> <br /> -2- <br />3. Address and Phone Number of 119 South Blvd., Box 1105 <br /> Local Offices Gunnison, CO 81230 <br /> 641-2014 <br />4. Address and Phone Number of <br /> General Offices Same as No. 3 <br />5. Name and Phone Number of Person Fred Schmalz, President <br /> Staff Members Should Contact 641-2014 <br />6. Owner(s) of Record of Affected Land Matt Hollenbeck <br /> (surface area) (If more than 2, list below) <br />7. Owner(s) of Substance to be Mined Hollenbeck, Inc. <br /> (If more than 2, list below) <br />8. Source of Legal Right-To-Enter Notarized statement <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 <br /> (Specify underground, open pit, Open pit, Sand and Grave <br /> quarry, etc. & substance(s) to <br /> be mined) <br />10. General Location and Elevation <br />(Miles & direction from nearest <br />APProx. 6.5 mi. SE of Gunn <br />'son <br /> town & approximate site elevation) Elveation: 7,480 ft. M.S. . <br />11. County Gunnison <br />12. Acreage of Affected Lands 9.9 ac. <br /> (Total surface acreage to be <br /> included in permit) <br />13. Application Fee (See applicable $125 <br /> Rule to determine amount) <br /> <br />