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-3- <br />10. Location information: The center of the area where the majority of mining will occur lies in: <br />COUNTY: '~~~/L°r <br />PRINCIPAL MERIDIAN (check one): _~ 6th (Colorado) _ 10th (New Mexico) _ Ute <br />SECTION (write number): S ~I <br />TOWNSHIP (write number and check direction): T ~2 North ~/ South <br />RANGE (write number and check direction): R 7 ~ _ East / West <br />QUARTER SECTION (checlr one): _ NE / NW _ SE _ SW <br />QUARTER/QUARTER SECTION (check one): _~ NE ~ NW ~ SE _ SW <br />GENERAL DESCRIP'PION (miles and direction from nearest town and approximate elevation): <br />11. Primary future (Post-minirro) lead use (check one): <br />Cmpland(CR) _ Pastureland(PL) _ S,eneral Agticalture(GA) <br />_ Rangeland(RL) _ Forestry(FR) _/Wildlife Habifat(WL} <br />_ Residential(RS) _ Recreation(RC) _ IndoslriaUCommercial(IC) <br />Developed Water Resaurces(R'R) _ Solid Waste Disposal(R'D) <br />12. Primary nreaent Fend axe (cheek one): <br />Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA) <br />_ Ran~land(RL) _ ForestrylT'R) Wildlife Habitat(WL) <br />_ Itesidential(RS) _ Recreation(RC) i IndustriaVCommercial(IC) <br />Developed Water Resources(Wlt) ~I9fming(MIV) <br />13. If this operation will use designated chemicals, or will resui; or presently has acid minedrainage - you cannot use this <br />application form You must submit a either a I lOd or 112d application form for Designated Mining Operations. III either <br />case, you muse list any acidic or toxic-forming materials, exposed or disturbed as a resiilt of the mining operation, and <br />whether t}re operation will result in or presently has acid mine drainage: <br />14. DeserinM1ioa of Conversion: If you are converting an existing operation, provide a brief narrative describing the proposed <br />I5. Moos & Exhibits: Submit two (2) comatete, unbound conies of the following application exhrbifs: <br />6.3.1 EXIIIBIT A -Legal Description and Location Map <br />6.3.2 EXIIIBIT B -Site Description <br />6.3.3 EXIBBIT C -Mining Plan <br />6:3.4 EXHIBIT D -Reclamation Plan <br />6.3.5 EXHIBIT E -Map <br />6.3.6 EXHIBIT F -List of Other Permits and Licenses Required <br />6.3.7 EXHIBIT G -Source of Legal Right-to-Enter <br />6.3.8 EXHIBIT H -Municipalities Within aTwo-mile Radius <br />6.39 EXI-IIBIT I -Proof of Filing with County Clerk <br />6.3.10 EXHIBTT J -Proof of Mailing Notices of Permit Application <br />6.4.19 EXHIBIT S - (as required) <br />6,5 Geotechnical Stability Exhibit (as required) <br />