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~- . • ~ III IIIIIIIIIIIII III ~R~~~~~ JUN 2 1988 REGULAR (112) PERMIT MINED LAND APPLICATION FORM DECLAMATION DIVISION This form contains two major parts: (1) General Operation Information and (2) Exhibits A-P. When you submit your application, be sure to include four si~~ne~~d copies of the General Operation Information, four copies of Exhibits A-P, and as cFe~c 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, 1n the space provided, all Information described below. 1. Applicant/Operator Name: Central Aggregates, Inc. 2. Operation Name (Pit, mine or site name): West Rifle Pit 3. Application type: Regular (112) Permit Operation. 4. Application Fee for Permitted Acreage* (;50.00 + E15.00/acre, 1st. 50 acres; E10.00/acre, 2nd. 50 acres.; E5.00/acre, 3rd. 50 acres; E1.00/acre, any additional acreage; maximum fee of Note permitted acreage and application fee and attach a check for this amount when you file. 57 permitted acres . 350.00 application fee. 5. Substance(s) to be mined (e.g., gold/silver/gravel): Sand and Gravel 6. Owners (s) of Substance to be Mined (check applicable box (s )): Private State Federal Indian 7. Owner(s) of Record of Affected Land (check applicable box (s )): Private State Federal Indian 8. Type of Mining Operation (check applicable box(s)): Surface Underground In-situ 9. Location Information. The center of the area where the majority of mining will occur lies in: COUNTY: PRINCIPLE c ec one 6th (Colorado) 10th (New Mexico) TOWNSHIP (write number and check direction): T _~ North South RANGE (write number and check direction): R ~ East Wes SECTION (write number): 5 QUARTER SECTION (check one): ~ NW SE SW QUARTER/QUARTER SECTION (check one): NE NW SE SW GENERAL DESCRIPTION: (miles and direction Adjacent to City Limits & approximately 1 mile from nearest town and c r o e i y o i e a approximate elevation) elevation 5280'. * 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.