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- 2 - 6. Name of owner of the subsurface rights of affected land:~p /S i C N,HH,C i7 ~e A'~. iv c .`NC .!v /L i e lr ry R D h~ r lCi NS 7. Name of owner of the surface of affected laced: Sec!~2. ~ ~-.M . 7.1 Names of the holders of any recorded easements on the affected land: 8. Type of mining operation: ~Srurface ` Underground In-situ 9. Location information: The center of the area where the majority of mining will occur: COUNTY: ~ n ~n r7 ~ 5 PRINCIPAL MERIDIAN (check one): 6th (Colorado) ~C10th (New Mexico) Ute SECTION (write number): S ~ f 7 TOWNSHIP (write number and check direction): T ~2 1~ North South RANGE (write number and check direction): R ~_ East LL West QUARTER SECTION (check one): NE ~/NW SE SW QUARTER/QUARTER SECTION (check one): 4iNE NW SE SW GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the approximate elevation) : ~X M i ~P.S d~~-+r n n ~i E (~. Y e c ,c (o„ ~~ k/~(~ ~ 10. Primary future (Poet-mining) laced use (check one): Crop land(CR) Pastureland(PL) General Agriculture(GA) _ Rangeland(RL) Forestry(FR) Wildlife Habitat(WL) _ Residential(RS) Recreation(RC) Industrial/Commercial(IC) Developed Water Resources(WR) Solid Waste Disposal(WD) 11. Primary present lead use (cheek one): Cropland(CR) Pastureland(PL) General Agriculture(GA) Rangeland(RL) Forestry(FR) ~iWfldlife Habitat (WL) _ Residential(RS) Recreation(RC) Industrial/Commercial(IC) _ Developed Water Resources (WR) Mining (MN) 12. If this operation will use designated chemicals, or will result, or presently has acid mine drainage - you cannot use this application form. You must submit either a 110d or 112d application form for Designated Mining Operations. In either case, you must list any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and whether the operation will result in or presently has acid mine drainage: N'r~iV ~ 13. Description of Amendment or Conversion: If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s):