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-2- REGULAR (i~l/ :.. RNiT APPLICATION • FORM ZI. Ce:Seral Location and Elevation I 7720 ft. (miles and direction from 3 miles northwest of Crestone nearest town and approximate site elevation) 12. County Saguache 3a. Total Surface Acreage to be In- cluded in Permit. (see Rule L 1(2)) 20 acres 3b Total Acreage of Affected Lands . (see Rule 2.11(14)) 18.30 acres 14. Application Fee (see RULE 2 to none - County government determine amount, based on permitted area) 15. Present Land Use (i.e., agri- cultural, industrial, etc.) Range land, with existing gravel pit 16. Surrounding Land Uses Range land I7. Proposed Future Land Use (final vse after reclamation) Ran e land Z8. List Mining Operations Currently none In Violation of Gye Act. (see 34-32-120) 19. The Lands Herein Do Not Affect affirmed any of the Lands Described in Section I15(4)(f) of the Mined Land Reclamation Act. (specify affirmation) MAPS AllD EXHIBITS With each of the five (5) copies of the application form, the applicant must submit a correspond- ing set of the maps and exhibits outlined in RULE 2, as follows: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1Z. 12. I3. I4. 15. 16. EXHIBIT A - Legal Description EXHIBIT B - Index Map EXHIBIT C - Pre-mining and .Ni Wing Plan Map(s) of Affected Lands EXHIBIT D - Mining Plan EXHIBIT E - Reclamation Plan EXHIBIT F - Reclamation Plan Map EXHIBIT G - Water Information EXHIBIT H - Wildlife Information EXHIBIT I - Soils Information EXRIBIT J - Vegetation Information EXHIBIT K - Climate EXHIBIT L - Reclamation Costs EXHIBIT M - Compliance with Local Zoning J EXHIBIT N - Other Permits or Licenses ) EXHIBIT O - Source of Legal Right to Enter ) EXHIBIT P - Owners of Record of Surface and Subsurface Rights) See 34-32-I15(4)(e)& 109(6)&(8) See 34-32-IIS(4) &(4) (c) See 34-32-Z12(21(d) See 34-32-I12(2)(b)&(c)