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. . r III IIIIIIIIIIIIIIII ~ ~~~~~vEG -~.~ APR 201992 LIMITED IMPACT ,OPERATION (110(2)) Ml~gd ~~ RECLAMATION PERMIT Reclamation Divlsior APPLICATION FORM The application for a Limited Impact Operation Reclamation Permit contains three major parts: C.l) the application form; (2) Exhibits A-J; and, (3) the application fee. When you submit your application, be sure to include two (2) signed originals of the application form, two (2) copies of Exhibits A-J, and a check for the application fee described under (3) below. To expedite processing, please provide the information in the format and order, described in this form. ~- ~1 L~- - per- a,[~~~ '~ vaaaa=aaaaaa----aaaaaaaaa- -aoaeaaaeaaaa----a a-aaeeavee-a -a P-a- _-a-a ~-____==a.a GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, all information described below. aaaaaaaaaaaaaaaae=vaaaaaaeeeaaaaaaaaaaaeeavavaaeveeeaae=aaaeaae=aaeeaaeevaacevaaaeooeav== 1. Applicant/operator name: Peck, Inc. 2 3 4 5 6 1.1 Type of .organization (corporation, partnership, etc.): Corporation Operation name (pit, mine or site name): Peck Pit 2.1 I.R.S. Tax ID No. or Social Security No.: Permitted acreage 8 permitted acres 3.1 Application Fee Substance(s) to be mined (e.g., gravel/gold/borrow): Name of owner of surface of affected land: 5875.00 application fee Gravel Nick Peck S Allan walz Name of owner of subsurface rights of affected land: Nick Peck 6. Allan walz 7. Type of mining operation: X Surface _ Underground _ In-situ 8. Location information. The center of the area where the majority of mining will occur lies in: COUNTY: Ouray PRINCIPAL MERIDIAN (check one): 6th (Colorado) x 10th (New Mexico) Ute TOWNSHIP (write number and check direction): T ~ x North South RANGE (write number and check direction): R ~ East ~ West SECTION (write number): S ~- QUARTER SECTION (check one): NE _ NW SE x SW QUARTER/QUARTER SECTION (check one): _ NE _ NW x SE _ SW G"cNERAL DESCRIPTION: (miles and direction 5 Miles North of Ouray, Co. from nearest town and approximate elevation) 7200 feet