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• <br />-2- <br />3. Address and Phone Number of <br />Local Offices <br />2138 J 50 Road, Austin, Colorado 81410 ~5-3127 <br />4. Address and Phone Number of <br />General Offices <br />2138 J 50 Road, /WStin, Colorado 81410 835-3127 <br />5. Name and Phone Number of Person <br />Staff Members Should Contact <br />Dwight D. Benson 835-3127 <br />6. Owner(s) of Record of Affected Land <br />(surface area) (If more than 2, list below) <br />A Partnership <br />7. Owner(s) of Substance to be Mined <br />(If more than 2, list below) <br />Dwight D. Benson and T. Edward Benson <br />8. Source of Legal Right-To-Enter <br />(Indicate what type of proof is <br />included in EXHIBIT G -lease, <br />deed, notarized letter, etc.) <br />Warranty Deed <br />9. Type of Mine and Substance to be Mined <br />(Specify underground, open pit, <br />quarry, etc. & substance(s) to <br />be mined) <br />Quarry - Sand and Gravel <br />10. General Location and Elevation <br />(Miles & direction from nearest <br />town & approximate site elevation) <br />4 miles 4kst frun Austin, Colorado - 4.980 feet aMvP CPd 1PVPI_ <br />11. County <br />12. Acreage of Affected Lands <br />(Total surface acreage to be <br />included in permit) <br />8.32 <br />13. Application Fee (See applicable <br />Rule to determine amount) <br />Fri c+iny Mine _ Tran~fe~,~of a;nershio <br />