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1 <br />t <br />' REGULAR (112) PERMIT <br />APPLICATION FORM <br />This form contains two maJor parts: (1) General Operation Information and (2) Exhibits <br />A-P, Nhen you submit your application, be sure to include four --siggn~ed copies of the <br />' General Operation Information, four copies of Exhibits A-P, and ask 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 />szeeseeeeeeevecvoeaezzvzeeevzeeeeezzee=ezzcoszzees:zs:ze:za~eeesa~ezeeeae¢ecveevsexcece.c <br />' GENERAL ODERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />' 1. <br />2. <br />' 3. <br />' 4. <br />1 <br /> <br />Applicant./Operator Name: c a ri companies <br />Operation Name (Pit. nine or site name): ~istel Farm resource <br />Application type: Regular (112) Permit Operation. <br />Application Fee for Permitted Acreage* <br />(550.00 •t 515.00/acre, 1st. 50 acres; <br />:10.00/acre, 2nd. 50 acres; 55.00/acre, 3rd. 50 acres; <br />51.00/acre, any additional acreage; maximum fee of <br />52,000.00).* <br />Note permitted acreage and application fee and <br />attach a check for this amount when you file. <br />t t a permitted <br />ac res. <br />$137o.O0application fee. <br />5. Substance(s) to De mined (e. g., gold/silver/gravel): sand a gravel <br />' 6. Owners(:) of Substance to be Mined <br />(check applicable box(:)): ® Private ^ State ^ Federal ^ Indian <br />7. Owner(s) of Record of Affected Land <br />(check applicable box(:)): 6) Private ^ State ^ Federal ^ Indian <br />' 8. Type of Mining Operation <br />(check applicable box(:)): I~ Surface ^ Underground ^ In-situ <br />9, location Information. The center of the area where the maJority of mining will <br />' occur lies in: <br />COl1NTY: <br />' PRINCIPLE ER N c ec: one ~ p 6th (Colorado) ^ 10th (New Mexico) ^ Ute <br />TOWNSHIP (write number end check direction): T ~_ p North ^ South <br />RAWGE (write number and check direction): R -~_ ^ East p West <br />' SECTION (write number): S <br />QU~4RTER SECTION (check one): O~ ^ NW ^ SE ®c SM <br />QUARTER/QUARTER SECTION (check one): p NE ^ NW ~p SE O SW <br />GENERAL DESCRIPTION: <br />t (miles and direction 3 miles east of Longmont <br />from nearest town and <br />approximate elevation) Rla~,ar;nn• dAAn <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 />