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• Corrected RECEIVED FE6 1219 - ~` ~~AAmera~s &geob9Y 6. Name of oxaer of the subsurfacevst~~A'Ch of affected land:Homer Monks Construction, Inc. 7. Name of owner of the surface of affected land: Homer Monks Construction, Inc. 7.1 Names of the holders of any recorded easements on the affected land: 8. '14oe of miniao operation: X Surface Underground In-situ 9. Location information: The center of the area where the majority of mining will occur: COUNTY: Elbert PRINCIPAL MERIDIAN (check one): X 6th (Colorado) 10th (New Mexico) Ute SECTION (write number): S TOWNSHIP (write number and check direction): T 9 North X South RANGE (write number and check direction): R 57 East X West QUARTER SECTION (check one): NE NW X SE SW QUARTER/QUARTER SECTION (check one): NE X NW SE SW GENERAL DESCRIPTION: (the number of miles and direction fr om the nearest town and the 6 miles southeast of Limon, North of Highway 29 approximate elevation): elevation 5720 10. Pr++~=+s future (Post-minimal land use (check one): _ Cropland(CR) PasturelandlPL) General Agriculture(GA) X Rangeland(RL) Forestry(FR) Wildlife Habitat(WL) Residential(RS) Recreation(RC) Industrial/COmmercial(IC) _ Developed Water Resources(WR) Solid Waste Disposal (W D) 11. Pr++~=~ oresent laced use (check one): _ Cropland(CR) Pastureland(PL) General Agriculture(GA) ~ Rangeland(RL) Forestry(FR) Wildlife Habitat(WL) _ Residential(RS) Recreation(RC) Industrial/COmmercial(IC) _ Developed Water Resources (WR) Mining (MN) 12. If this operation will use designated chemicals, or will result, or presently has acid mine drainage - you cannot use this application form. You must submit either a 110d or 112d application form for Designated Mining Operations. In either case, you must list any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and whether the operation will result in or presently has acid mine drainage: There will be no acid or toxic-forming materials used, exposed or disturbed as a result of this mining operation. Materials involved are sand and gravel which are basically chemically inert. 13. Descriation of Amendment or Conversion: If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s):