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• .• ~`$; <br />4 '' <br />~ RECLAMAO TIONT PERMIT 2 ) ~~~ ~+ ly~~ <br />', APPLICATION FORM <br />CHECK ONE: New d(~~8i00 u'~'~''~ ~ <br />Application (Rule 1,4.5) AmentlE ~ "~n (Rule 1.10) <br />X Conversion Application (Rule 1.11) .,, <br />Permit No. M- 78 - 268 (provide for amendments and conversions of existing <br />The application £or a Regular Operation Reclamation Permit contains three major parts: (1) <br />' the application form; (2) Exhibits A-S and Geotechnical Stability Exhibit; and, (3) the <br />application fee. When you submit your application, be sure to include one (1) signed and <br />notarized original and four (4) copies of the application form, five (5) copies of Exhibits <br />A-R and any required sections of Exhibit S and the Geotechnical Stability Exhibit, and a <br />' check for the application fee described under Section (16) on Page 3. Exhibits should not <br />be bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" or 8 1/2^ X 14^ size. <br />To expedite processing, please provide the information in the format and order described <br />in this form. - <br />----------------------------------------- <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the apace provided, all information described below. <br />------_- <br />---------- --- <br />__________________ <br />l. Applicant/operator or company name (name to be used on pezmit): <br />Ouray County <br />' 1.1 Type of organization (corporation, partnership, etc.): Government <br />1.2 I.R.S. Tax ID No. or Social Security Number: <br />2. Operation. name (pit, mine or site name): Dallas Gravel Pit <br />t 3.' Permitted acreage (new or existing site) 9.5 permitted acres <br />3.1 Change in acreage (+ or -) 8.85 acres <br />3.2 Total acreage in Permit area 18.35 acres <br />' 4. Fees: <br />4.1 New Application 51,875.00 application fee <br />4.2 New Quarry Application 52.325.00 quarry application <br />4.3 Milling Application (Non-DMO) S3,100.00 milling application <br />4.4 Amendment Fee __$1.550.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) _ $l.SDD.OD conversion fee <br />' S. Primary coumioditie(s) to be mined: Gravel <br /> 6. Name of owner of surface of affected land: United States <br /> 7. Name of owner of subsurface rights of affected land: United States <br />If 2 or more owners, refer to Exhibit O. <br />' <br /> 8. Type of mining operation: X Surface _ IInderground In-situ <br /> 9. Location Information: the center o£ the area where the majority of, mining will <br /> occur lies in: <br /> . CODNTY: Ouray <br /> PRSNCIPAL MERIDIAN (check one): _ 6th (Colorado) X 10th (New Mexico) <br />IIte <br /> _ <br />SECTION (write number): S <br />' TOWNSHIP (write number and check direction): T X North South <br /> RANGE (write number and che : R East ~ <br />West <br /> _ <br />QIIARTER SECTION (check one): NE ~, NW <br />Sfi <br />SW <br /> _ <br />_ <br />QIIIIRTER/QLII1RTfiR SECTION (check one): ~ NE NW SE SW <br /> GENERAL DESCRIPTION (mrles and direction from nearest town and approximate <br /> elevation): 3.67 Miles Northeast of Rid4eway at approximately 7400 <br /> Feet in elevation. <br /> <br /> <br />1 <br />permits) <br /> <br />