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t <br />~: <br />-3- <br />10. <br />11. <br />12. <br />I oration tnfnrmatlnn~ The ranter of the area where the majority of mining will occur lies in: <br />COUNTY: <br />PRINCIPAL MERIDIAN (check one): 6th (Colorado) 10th (New Mexico) Ute <br />SECTION (write number): S <br />TOWNSHIP (write number and check direction): T North South <br />RANGE (write number and check direction): R East West <br />QUARTER SECTION (check one): _ NE _ NW , SE - SW <br />QUARTER/QUARTER SECTION (check one): _ NE _ NW _ SE _ SW <br />GENERAL, DESCRIPTION (miles and direction from nearest town and approximate elevation) <br />Primary fu .re iP.wt-minim land ace (ph ecic noel; <br />- Cropland(CR) - Pas[ureland(PL) _ General Agriculture(GA) <br />Rangeland(RL) _ Forestry(FR) _ Wildlife Habitat(WL) <br />_ Residential(RS) _ Recreation(RC) _ IndustriaUCommercial(IC) <br />Developed Water Resources(WR) _ Solid Waste Disposal(WD) <br />Primary Prvicent land nce (fherlc noel; <br />Cropland(CR) - Pastureland(PL) _ General Agriculture(GA) <br />Rangeland(RL) _ Forestry(FR) _ Wildlife Habitat(WL) <br />_ Residential(RS) _ Recreation(RC) _ Lndus[riaUCommercial(IC) <br />Developed Water Resources(WR) _ Mining(MN) <br />13. If this operation will use designated chemicals, or will result, or presently has acid mine drainage -you cannot use this <br />application form. You must submit a either a 110d or 112d application form for Designated Mining Operations. In either <br />case, you must list any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and <br />whether the operation will result in or presently has acid mine drainage: <br />14. Dexc^~ rtn~ of f'nn~er.:nn; ff you aze converting an eacisting operation, provide a brief narrative describing the proposed <br />change(s): <br />15. Manc .~ Fchihitc~ Submit two (Z) rmm~lere .mh~n.nd rnniec of the following application exhibits: <br />6.3.1 EXIIIDIT A -Legal Description and Logtion Map <br />6.3.2 EXFIIBIT B -Site Description <br />6.3.3 E3tTIIBIT C -Mining Plan <br />6.3.4 E7CHIBff D -Reclamation Plan <br />6.3.5 EXI~IIBIT E -Map <br />6.3.6 EXIIIBTT F -List of Other Permits and Licenses Required <br />6.3.7 EX1iIBIT G -Source of Legal Right-to-Enter <br />6.3.g EXI~BIT H -Municipalities Within aTwo-Hole Radius <br />6.3.9 EXIEBIT I -Proof of Filing with County Clerk <br />6.3.10 EXIIIBIT J - Proof of Mailing Notices of Permit Apptigtion <br />6.3.12 EXIIIBIT L -Permanent Man-Made Structures <br />6.4.19 EXIIIBIT S - (as required) <br />6.5 Geotechnical Stability Exhibit (as required) <br />