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.. ~ • <br />h y(, <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 ~siggn~ed copies of the <br />General Operation Information, two copies of Exhibits A-G, and as e k 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: 3achelor silver ;pines Co., Inc. <br />2. Operation Name (Pit, mine or site name): ;ache to Khedive I.~ne i' <br />3. Application type: Limited Impact Operation (11 /~ <br />4. Application Fee for Permitted Acreage* 2 permitted acres. <br /> (E10 x (affected acres) + E25.00).* <br /> • Note permitted acreage and application fee and <br /> attach a check for this amount when you file. ~45.0o application fee. <br />5. Substance(s) to be mined (e.g., gold/silver/gravel): cold, silver, lead, <br /> copper, zinc <br />6. Owners(s) of Substance to be Mined <br /> (check applicable box(s)): \Lk Private ^ State ^ Federal ^ Indian <br />7. Owner{s) of Record of Affected Land <br /> (check applicable box(s)): K~{Private ^ State ^ Federal ^ Indian <br />8. Type of Mining Operation <br /> (check applicable box(s)): ~1 Surface XI~CUnderground ^ In-situ <br />9. Location Information. The center of the area where the majority of mining will <br /> occur lies in: <br />COUNTY: Oura <br />PRINCIPLE MERIDIAN checc one ^ 6th (Colorado) ~ 10th (New Mexico)^ Ute <br />TOWNSHIP (write number and check direction): T i 4 ~{ North ^ South <br />RANGE (write number and check direction): R ~ ^ East ~ West <br />SECTION (write number): S 18 <br />QUARTER SECTION (check one)%ast 2 Of .Jig ®~ ^ NW 1~. SE ^ SW <br />QUARTER/QUARTER SECTION (check one): ^ NE ^ NW l;X SE ^ SW <br />GENERAL DESCRIPTION: <br />smiles and direction ~ 5 north n. Ourav <br />from nearest town and <br />approximate elevation) RKO~~ ?levat ;on <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 />