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III IIIIIIIIIIIIIIII <br />~~Ylc~q~~`' <br />LIMITED IMPACT OPERATION t110t2)> <br />RECLAMATION PERMIT <br />APPLICATION FORM <br /> <br />=€d z s t992 <br />Mined land <br />The application for a Limited Impact Operation Reclamation Permit contains three major <br />parts: (1) the application form; (2) Exhibits A-3; and, (3> the application fee. When <br />you submit }'our application, 6e sure to include two (2) signed originals of the <br />application form, two (2) copies of Exhibits A-J, and a check for the application fee <br />described under (3> below. To expedite processing, please provide the information in <br />the format and order described in this form. ~ 7-~~ <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/operator name: M. SIMS GRAVEL COMPANY <br />T;~pe of organization (Corporation, partnership, etc.):M. SIMS GRAVEL COMPANY <br />2 <br />3 <br />Operation name (pit, mine or site name) <br />EAST DOUGLAS PIT <br />2.1 I.R.S. Tax ID No. or Social Security,No.: <br />Permitted acreage ( .LUS 4.4~ <br />3.1 Application Fee <br />3875.00 application fee <br />4. Substance(s) to be mined (e.g., gravellgold/borrow): GRAVEL <br /> <br />5. Name of ~~wner of surface of affected land: FEDERAL <br /> <br />6. Name of ~~wner of subsurface rights of affected land: F'FS)ERAL <br /> <br />7. Type of mining operation: % Surface _ Underground _ In-situ <br />8. Location information. The center of the area where the majority of mining will <br /> occur lies in: <br /> COUNTY: RIO BLANCO <br /> PRINCIPAL MERIDIAN (check one): R 6th (Colorado) 10th (New Mexico) _ Ute <br /> TOWNSHIP (write number and check direction): T 2S _ North R Soutr <br /> RANGE (write number and check direction): R lol _ Edst R West <br /> SECTION (write number): S 35 <br /> QUARTER SECTION (check one): X NE R NW R SE _ S:~ <br /> QUARTER/QUARTER SECTION (check one): R NE % NW % SE _ 5:~ <br />GENERAL DESCRIPTION <br /> <br />7.~ permitted acres <br />(miles and direction APPROXIMATELY 21 MILES SOUTH OF RANGELY <br />from nearest town and <br />approximate elevation) ELEVATION 6090 <br />