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~ ~ <br /> <br /> • • <br /> -2- <br />3. Address and Phone Number of 3420 Meade St. Denver Colo. <br />Local Offices + ~ 0211 303-455- <br />4. Address and Phone Number of 3420 Meade St. , Denver, Colo. <br />General Offices 0211 303-455- <br />5. Name and Phone Number of Person Douglas Bachli 303-429-b51o <br />Staff Members Should Contact <br />6. Owner(s) of Record of Affected Land Douglas Bachli <br /> (surface area) (If more than 2, list below) Wayne L. Phipp s <br />7. B <br />ili <br />ugea <br />Owner(s) of Substance to be Mined ~ W <br /> Ph <br />a <br />L. <br />(If more than 2, list below) YID PP s <br />8. Source of Legal Right-To-Enter <br /> (Indicate what type of proof is Deed to Douglas Bachli & Wa e L.Phipps <br /> included in EXHIBIT G - lease, <br /> deed, notarized letter, etc.) <br />9. Type of Mine and Substance to be Mined <br /> (Specify underground, open pit, Open pit, Stratified f ag.~tone (Sand; <br /> quarry, etc. & substance(s) to <br /> be mined) <br />10. General Location and Elevation <br /> (Miles & direction from nearest Approximately 5 miles N rtllwest of Loy <br /> town & approximate site elevation) Colo. Approx, elevation of 5~f400 f t. <br />11. County Larimer <br />12. Acreage of Affected Lands <br /> (Total surface acreage to be 2 acres <br /> included in permit) <br />13. Application 'Fee (See applicable <br /> Rule to determine amount) <br /> 34~~~, <br />~}Iso; ~~~ <br /> ~ <br /> 6~ Zs'~L LaW ~ ~l ~Bl~ul <br /> ~e+~acr, CO ~,p yZ.l <br />7551 <br />7551 <br />stone) <br />Deland <br />