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- ~ iii iuiiiiiiiu iii ~~~~~ ,~~ <br />'~ RsGIILAR OPERATION (112) OCT 1 g 1995 <br />RHCLAMATION PERMIT <br />APPLICATION FORM <br />Dlvisbn of Minerals 8 Geology <br />' CHBCIC ONE: New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />X Conversion Application (Rule 1.11) <br />Permit No. M- 78 268 (provide for amendments and conversions of existing <br />permits) <br />The application for a Regular Operation Reclamation Permit contains three major parts: (1) <br />' the application form; (2) 8xhibits A-S and Geotechaical 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 8xhibits <br />A-R and a~ required sections of Hxhibit S and the Geotechnical Stability 8xhibit, 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 B 1/2" % il" or s 1/2" X 14" size. <br />To expedite processing, please provide the information in the fozmat and order described <br />is this form. <br />----------- - -------- -------------- <br />. GBNSRAL OPERATION INFORMATION <br />Type or print clearly, is the apace provided, all information described belor. <br />1. Applicant/operator or c~paay name (same to be used on permit): <br />Horny (`nnn y <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 /> 3. Permitted acreage (aer or existing site) 9.5 permitted acres <br />' 3.1 Change in acreage (+ or -) +40.5 acres <br /> 3.2 Total acreage is Permit area 50 acres <br />' 4. Fees: <br /> 4.1 Ner Application 51.675.00 application fee <br /> 4.2 Ner Quarry Application S2.325.00 quarry application <br />' 4.3 Milling Application (Non-DMO) 53.100.00 milling application <br />4.4 Amendment Fee 51.550.00 amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) 51.500.00 conversion fee <br /> S. Primary commoditie(s) to be mined: Gravel <br />' i <br />d <br /> 6. Name of saner of surface of affected land: Un <br />te <br />States <br /> 7. Name of saner of subsurface rights of affected land: United States <br /> If 2 or more orners, refer to 8xhibit O. <br />' 8. Type of mining operation: ~ Surface IIadergrouad In-situ <br /> 9. Location Information: the center of the area where the majority of.miaing will <br /> occur lies in: <br />' COIINT7C: Ol1I'aV <br /> PRINCIPAL MBRIDrnx (check one): _ 6th (Colorado) X 10th (Ner Mexico) <br />IIte <br />' _ <br />SHCTION (write number): S <br />TOWNSHIP (write number and check direction): T ~ North South <br /> RANGB (write num direction): R ~ Host ~( West <br /> QDARTHR SBCTION (check one): NH ~ NW _ SS <br />SW <br /> _ <br />QIIARTSR/QIDIRTBR SHCTION (check one): ~( RH NW SS SW <br /> GENERAL DBSCRIPTION (miles sad direction from nearest town and approximate <br /> elevation): 3.67 Miles Northeast of Ridgewav at approximately 7400 Feet in <br /> elevation. <br /> <br />1 <br />II <br />