Laserfiche WebLink
111 Illlll llllll 111 • REGULAR H • BAN 26 1996l <br /> 99 APPLICATION FORM nn 1t���° <br /> MMCK ONF'.: New Application (Rule 1.4 .5) Y Amendmenri*%I.V h s .&9Y10) <br /> Conversion Application (Rule 1 .11) <br /> Permit No. M- 78 - 172 (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) Exhibits 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 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 ar 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. yL 1 1 <br /> ---------- <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly, in the space provided, all information described below. <br /> --------------------------------------------------------------------------------------- <br /> 1. Applicant/operator or company name (name to be used on permit) : <br /> MCA COUNTY <br /> 1.1 Type of organization (corporation, partnership, etc.) : LOCAL GOVERNMENT <br /> 1.2 I.R.S_ Tax ID No. or Social Security Number: FEIN # 84-6000759 <br /> 2. Operation. name (pit, mine or site name) : ANTELOPE HILL GRAVEL PIT <br /> 3. Pennitted acreage (new or existing site) 15. 75 permitted acres <br /> 3.1 Change in acreage (+ or -) .{ 54.42 acres <br /> 3.2 Total acreage in Permit area 70.17 acres <br /> 4 . Fee3: <br /> 4.1 New Application $1,875.00 application fee <br /> 4.2 New Quarry Application $2,325.00 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 /> 5 . Primary commoditie(s) to be mined: GRAVEL <br /> 6. Name of owner of surface of affected land: HULTEEN ORCHARDS (James Hulteen) <br /> 7. Name of owner of subsurface rights of affected land: HULTEEN ORCHARDS (James Hulteen) <br /> If 2 or more owners, refer to Exhibit O_ <br /> 8. Typt of mining operation: X Surface _ Underground _ In-situ <br /> 9 . Location Information: the center of the area where the majority of. miaiac will <br /> oc== lies in: <br /> COUNT7: DELTA <br /> PRINCIPAL bSP=S.IAN (check one) 6th (Colorado) 10th (New Mexico) ` Cte <br /> SEC!,-ION (write number) : S L9 R "i0 <br /> TOWl75HIP (write number and check directica) : T L4 . _ North X South <br /> RANGE (write number and check direction) : R East x West <br /> Q=ZTER SECTION (check one) : _ NE _ NW _ SE _ SW <br /> QQARTER/QOARTER SECTION (check one) : NE NW SE SW <br /> GENERAL DESCRIPTION (miles and direction from neares= town and approximate <br /> elevation) : 2-� MILES SE OF ECKERT 5, 500 ELEVATION <br />