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~' III IIIIIIIIIIIIIIII • ~ i~ _2_ ~~~ 5• Name of owner of the subsu:eface rights of affected land: Robert C. Bledsoe Trust and Catherine L. Bledsoe Trust 7. Name of owner of the surfa~~e of affected land: Robert C. Bledsoe Trust and Catherine L. Bledsoe Trust 7.1 Names of the holders of any recorded easements on the affected land: N/A 8. Type of mining operation: X Surface Underground In-situ 9. Location information: The center of the area where the majority of mining will occur: COUNTY: KIT CARSON PRINCIPAL MERIDIAN (check one): / 6th (Colorado) 10th (New Mexico) Ute SECTION (write number): S 33 TOWNSHIP (write number and check direction): T 11 North / South RANGE (write number and check directioa): R 51 East / West QUARTER SECTION (check one): NE / NW SE SW QUARTER/QUARTER SECTION (check one): NE NW / SE SW GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the a^oro:<imate elevation) : __'-_!___-- .-'--=_=c1`h a,.d ? ~~i'_es zest of cla3le= Ann ro ximately SC55' in elevation 10. Primary future (Post-minima) land use (check one): _ Cropland(CR) / Pastureland(PL) General Agriculture(GA) _ Rangeland (RL) Fo restry(FR) Wildlife Habitat (WL) Residential(RS) Recrea tion(RC) Industrial/Commercial (IC) Developed Water Resources (WR) Solid 47a ste Disposal (WD) 11. primary present land use {check one): _ Cropland(CR) / Pastureland(PL) General Agriculture(GA) _ Rangeland (RL) Fo restry(FR) Wildlife Habitat (WL) _ Residential(RS) Recreation(RC) Industrial/Commercial (IC) Developed Water Resources (W R) Mining (MN) 12. If this operation will us~° designated chemicals, or will result, or presently has acid mine drainage - you cannon= 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 th•=_ operation will result in or presently has acid mine drainage: N/A 13. Description of Amendment or Conversion If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s): The proposed change includes increasing the acreage to the western boundary by 170', th~_ eastern boundary by 390', and southern boundary by 367'. (Amended to approx. 570'x680')