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~~ ~~~~~~E® ~,r,T ~,~~ 193$ LIMITED IMPACT OPERATION (110) ,~;~~L-C- ,_~_,,;p APPLICATION 7Fr-'! F•,~/!k!i^J+~i C;i`J`,51OSv This form contains two major parts: {1) p Operation Information and (2) Exhibits A-G. When you submit your application, be sure to include two s~~iggne~~d copies of the General Operation Information, two copies of Exhibits A-G, and as c~c-k for the application fee described under (4) below. To expedite processing, please provide the information in the format and order described in this form. GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, all information described below. 1. Applicant/Operator Name: Charles Leon Fedinec 2. Operation Name (Pit, mine or site name): Fedinec pit 3. Application type: Limited Impact Operation (110). Not 4. Application Fee for Permitted Acreage* Applicable permitted acres. (j10 x (affected acres) + E25.00).* Note permitted acreage and application fee and Noc attach a check for this amount when you file. Applicable application fee. 5. Substance(s) to be mined (e. g., gold/silver/gravel): sasalc aKKreQates 6. Owners(s) of Substance to be Mined (check applicable Dox(s)): iz# Private ^ State ^ Federal ^ Indian 7. Owner(s) of Record of Affected Land (check applicable box(s)): E# Private ^ State ^ Federal ^ Indian 8. Type of Mining Operation (check applicable box(s)): 1~ Surface ^ Underground ^ In-situ 9. Location Information. The center of the area where the majority of mining will occur lies in: COUNTY: Moffat PRINCIPLE M R D AN chec one isk 6th (Colorado) ^ 10th (New Mexico}^ Ute TOWNSHIP (write number and check direction): T 6 ® North ^ South RANGE (write number and check direction): R ~- ^ East ® West SECTION (write number): S ~~ QUARTER SECTION (check one): ^-R~ ^ NW ^ SE ^ SW QUARTERlQUARTER SECTION (check one}: ^ NE ^ NW ^ SE ^ SW GENERAL DESCRIPTION: (miles and direction 7 miles SE of Craig from nearest town and approximate elevation) 6,800' MSL * If the operator is a unit of State or county government, an application fee is not required. A fraction of an acre must be counted as one acre for fee calculation.