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GRAN <br />~ <br />~ <br />D COUNTY, CO g4013 <br />2 12/22/94 0337PM <br />O .00 , <br />PAGE 34 OF 43 SARA L ROSENE,RECORDER REC-FEE DOC-FEE APL <br />GRAND COUNTY, CO 94014031 12/23/94 0404PM 220.00 .00 J , <br />PAGE 35 OF 44 SARA L ROSENE,RECORDER REC-FEE DOC-FEE APL <br />~ <br />- - - - <br />y <br />... _ <br />. ' , <br />` <br /> <br />NOTICE ' <br />The Privacy Act of 1974 and the regulation in 43 CFR 2.48(d) ;~:~ir Inc .nat you be furnished the following <br />information in connection with information «quired by this ar ^:~..uun. <br />'.. <br />.. ~ AUTFiOR17V: 30 U.S.C. 601.602; 43 U.$C. 7201; 60 Stet. 367 .. ~ ~ ~ ~ ~ ,. <br />.- <br />PRINCIPAL PUflPOSE -The information is to be uxd to process your application for a Free Use Permu. <br />ROUTINE USES: ~ ~ ~ - - J ~ -- <br />~~ ~ ~ ~-,.' - - , ~ (1) The adjudication o(the applican[s' rights to the land or «soarces. ---" <br />~-~ ~ -' <br />___ ~ (2) Documentation for public information in support of notations made on land status records [or the - <br />~managemeni, disposal, and use o(public lands and resources. ~ ~~ . ~ ~ - -~-- <br />(3) Transfer [o appropriate Federal agencies when concurtence is required prior to grart[ing a right in ' <br />public lands or resources. <br />(4) Trans(ertotheU.S. DepanmentoCJustice in the even[of litigation involvingthe records or the subject <br />mat[cr of the records. <br /> <br />(5) Transfer, in the even[ there is indicated a violation or potential violation o(astatute, regulation, rule, , <br />order or license, wherhercivil, criminal or«gulatorv in nature, to the appropriate agency or agennes, <br />whether Federal, State, local or (oragn, charged with the responsibility of inveaigauon or prosecuting <br />such violation or charged with enforcing or Implementing the statute, rule, «gula[ion, order or license <br /> <br />violated or potentially violated. S , <br />EFFECT OF NOT PROVIDING INFORMATION - I(you do not furnish all the information required by this i <br />form, your applicatton may be rejected. , <br />The Paperwork Reduction Act of 1980 (44 U.S.C. 3501 et. seq.) requires us to inform you tha[: <br />__ <br />_ <br />_ <br />Information is being collected to obtain vegetal and mineral depletion Information relevant to natural <br /> <br />- - -~----~- -resource inventory. - - - ~ - - ~ ~ ' <br />- <br />_ _ _ Information will be used (or depletion records. <br />,response to this request is mandatory (63-SSIO) to fulfill the requirements for the cutting of timber and for <br />oil and gas claimants. ' <br /> <br /> <br /> <br /> <br /> 1 <br />