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VL.. 6t <br /> LIMITED IMPACT OPERATION (110) <br /> APPLICATION FORM <br /> This form contains two major parts: (1 ) General Operation Information and (2) Exhibits <br /> A-G. When you submit your application, be sure to include two s named copies of the <br /> General Operation Information, two copies of ,Exhibits A-G, and a check for the <br /> application fee described under (4) below. To expedite processing, please provide the <br /> information in the format and order described in this form. <br /> ----------------------------------------------------------------------- <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly, in the space provided, all information described below. <br /> 1 . Applicant/Operator Name: Bachelor Silver Mines Company, Inc . <br /> 2. Operation Name (Pit, mine or site name) : R..,...olor c i <br /> �rra use N inP <br /> 3. Application type: Limited Impact Operation (110) . <br /> 4. Application Fee for Permitted Acreage* 4 g5 permitted acres. <br /> ($10 x (affected acres) + $25.00) .* <br /> Note permitted acreage and application fee and <br /> attach a check for this amount when you file. $68, 50 application fee. <br /> 5. Substance( s) to be mined (e.g. , gold/silver/gravel ) : Gold , silver, lead, comer , <br /> zinc <br /> 6. Owners(s) of Substance to be Mined <br /> (check applicable box(s) ) : lZk Private ❑ State ❑ Federal ❑ Indian <br /> 7. Owner( s) of Record of Affected Land <br /> (check applicable box( s) ) : x&k Private ❑ State ❑ Federal ❑ Indian <br /> 8. Type of Mining Operation <br /> (check applicable box(s) ) : ❑ Surface xOx Underground ❑ In-situ <br /> 9. Location Information. The center of the area where the majority of mining will <br /> occur lies in: <br /> COUNTY: Ouray <br /> PRINCIPLE MERIDIAN (check one ❑ 6th (Colorado) Eax loth (New Mexico)❑ Ute <br /> TOWNSHIP (write number and check direction) : T 44 Ek North ❑ South <br /> RANGE (write number and check direction) : R 7 ❑ East OK West <br /> SECTION (write number) : S 13 <br /> QUARTER SECTION (check one) : ❑--Nr--- ❑ NW ly SE 9V SW <br /> QUARTER/QUARTER SECTION (check one) : ❑ NE ❑ NW D SE [Ax SW <br /> GENERAL DESCRIPTION: <br /> (miles and direction 2, mi-1e�- north�f „rat <br /> from nearest town and <br /> approximate elevation) 80501 ele•ratinn <br /> * If the operator is a unit of State or county government, an application fee is not <br /> required. A fraction of an acre must be counted as one acre for fee calculation. <br />