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999 <br /> REGULAR OPERATION (172) <br /> RECLAMATION PERMIT <br /> APPLICATION FORM <br /> CHECK ONE: New Application (Rule 2) Amendment Application (Rule l .f <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 /> aa=aaaaaaaa=aa=a=aaaava avvaavvaa aaaaaaaaav=aaaaa=aria=saavaaaaaaa=avaaaavav=aaaaaax=a-a= <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly, in the space provided, all information described below. <br /> aaa aaaaaaaaaaaaaavvaaaaaaaaaavaaaaaaaaaaaaaaaaaavaaavva=as=aaaaavaavaaava=aaaaavaaaaa=v= <br /> 1 . Applicant/operator name: Weld County, Colorado <br /> 1 . 1 Type of organization (corporation, partnership, etc . ) : Government <br /> 2 . Operation name (pit, mine or site name) : Thomas Pit No. 4 (conversion) <br /> 2 . 1 I .R.S. Tax ID No. or Socia ity No. : 98-03551 <br /> 3 . Permitted Acres : 75. 14 Permitted acre <br /> Please indicate acreage to the nearest tenth ( loth) acre. <br /> 3. 1 Application fee (see Section 14) : $1,500.00 Application fe <br /> 4 . Substance( s) to be mined (e.g. , gravel / ) : Gravel - Dry Pit <br /> 5. Name of owner of surface of affected land: Raymond & Ronald Thomas <br /> 6. Name of owner of subsurface rights of affected land: Raymond & Ronald Thomas <br /> If 2 or more owners , refer to Exhibit P. <br /> 7. Type of mining operation: X Surface _ Undergroun <br /> 8. Location Information: the center of the area where the majority of mining will <br /> occur lies in: <br /> COUNTY: Weld <br /> PRINCIPAL MERIDIAN (check one) : X 6th (Colorado) loth (New Mexico) _ Ute <br /> TOWNSHIP (write number and check direction) : T 8 X North South <br /> RANGE (write number and check direction) : R 61 _ East X West <br /> SECTION (write number) : S i <br /> QUARTER SECTION (check one) : _ NE x NW SE _ SW <br /> QUARTER/QUARTER SECTION (check one) : NE _ NW x SE _ SW <br /> GENERAL DESCRIPTION: <br /> (miles and direction Four miles west and one mile south of KEOTA, CO, <br /> from nearest town and <br /> approximate elevation) WCR 97 & 96, Elevation 5,050 <br /> 920939 <br />