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<br />-2- <br />3. Address and Phone Number of Phillips County Road Dist #1 <br />Local offices 53037 Rd 37 <br />Amherst, CO 80721 <br />4. Address and Phone Number Of Phillips County Commissioners <br />General Offices Phillips County Courthouse <br />221 S. Interocean, Holyoke, CO 80734 854-2454 <br />5. Name and Phone Number of Person Randy Schafer <br />Staff 1lembers Should Contact Phillips County Planner <br />Phillips County Courthouse, Holyoke. CO 854-3778 <br />6. Owner(s) of Record of Affected Land <br />(surface area) (If more than 2, list below) <br />Nancy Jo Kennedy <br />7. Owner(:) of Substance to be Mined <br />(If more than 2, list below) <br />Nancy Jo Kennedy <br />8. Source of Legal Right-To-Enter <br />(Indicz.te what type of proof is <br />includE~d in EXHIBIT G - lease, Notarized Agreement <br />deed, rotarized letter, etc.) <br />9. Type of Mine and Substance to be Mined <br />(Specify underground, open pit, <br />quarry, etc. & substance(s) to <br />be mined) Sand and Gravel <br />10. General Location and Elevation <br />(Miles & direction from nearest 7 Miles East <br />town & approximate site elevation) 2 Miles South and 3/4 E of Holyoke <br />Approximate site elevation 3630 <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 />Phillips <br />9.9 <br />Waived by legislature for counties <br />