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REDEIVED <br /> REGULAR OPERATION (112) MAY 2 5 1994 <br /> RECLAMATION PERMIT <br /> APPLICATION FORM <br /> Div;ftn c' Minerz!: t.Gccicny <br /> CHECK ONE: New Application (Rule 2) Amendment Application (Rule 1 .8) <br /> Conversion Application (Rule 1 . 10) <br /> The application for a Regular Operation Reclamation Permit contains three major parts: <br /> (1 ) the application form; (2) Exhibits A—S; and, (3) the application fee. When you <br /> submit your application, be sure to include one (1 ) signed original and four (4) signed <br /> copies of the application form, five (5) copies of Exhibits A—S, and a check for the <br /> application fee described under Section (14) on Page 3.. To expedite processing, please <br /> provide the information in the format and order described in this form. <br /> asszaaszaaaz caac avzzazvav vcc vavzvzzssazaysavzavvvvazvvvavzavvvvvavavvavv a aY avza vvv <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly, in the space provided, all information described below. <br /> ccvczszszzacaazcccccacaaccccssssacssszzasccccacsvzssaazssssvaasassazavavaavvvcvvavavcazzv <br /> 1 . Applicant/operator name: L. er and Jacque Goemmer (Mrs . Otto) <br /> 1 . 1 Type of organization (corporation, partnership, etc.) : operator/owner <br /> 2. Operation name (pit, mine or site name): Rocky Flat Gravel <br /> 2. 1 I.R.S. Tax ID No. or Social Security No. : 521-44-5857 <br /> 3. Permitted Acres: 9 . 90 Permitted acres <br /> Please indicate acreage to the nearest tenth (10th) acre. <br /> 3.1 Application fee (see Section 14): $1500 .00 Application fee <br /> 4. Substance(s) to be mined (e.g. , gravel/gold/borrow): gravel, borrow <br /> 5. Name of owner of surface of affected land: Jacque Goemmer <br /> 6. Name of owner of subsurface rights of affected land: Jacque Goemmer <br /> If 2 or more owners, refer to Exhibit P. <br /> 7. Type of mining operation: x Surface _ Underground <br /> 8. Location Information: the center of the area where the majority of mining will <br /> occur lies in: <br /> (AUNTY: Huerfano <br /> PRINCIPAL MERIDIAN (check one) : x 6th (Colorado) loth (New Mexico) Ute <br /> TOWNSHIP (write number and check direction) : T 2-9 North x South <br /> RANGE (write number and check direction) : R 6 _ East x West <br /> SECTION (write number) : S 32 <br /> QUARTER SECTION (check one) : NE NW x SE SW <br /> QUARTER/QUARTER SECTION (check one) : _ NE x NW _ SE _ SW <br /> GENERAL DESCRIPTION: <br /> (miles and direction Located 2 . 5+ miles southerly direction from <br /> from nearest town and La Veta, Colorado, at approxima e y <br /> approximate elevation) in elevation. _ <br />