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n <br />LJ <br />-2- <br />R~LRR (I12) P2~;KNIT APPLICATION <br />FORM <br />11. General Location and Elevation I 16 mlles southwest Of !•ldtUritd, COlordd0 <br /> (miles and direction from <br />t t <br />t <br />d <br />i <br /> neares <br />own an <br />approx <br />ma <br />e <br />site elevation) <br />570C' elevation <br />Zz. county San P•1iguel <br />:3a. Total Surface Acreage to be In- <br />cluded in Permit. (see Rule Z I(2)) <br />755 acres <br />3b To tat Acreage of Affected Lands <br />(see Rule 2.11(14)) 40 dCres <br />14. Application Fee (see RULE 2 to <br /> determine amount, based on <br />permitted area) <br />I5. Present Land Use (i.e., agri- <br />cultural, industrial, etc.) <br />Ptjnjng <br />15. sarrounding Lana uses h1ining, Rangeland, l~lildlife liabitat <br />17. Proposed Future Land Use (final <br />use after reclamation) Ran eland, l•Jj ldljfe <br />9 Hdbjtdt <br />18. List Mining Operations Currently <br /> In violation of the Act. (see <br />39-32-120) <br />Nane <br />19. The Lands Herein Do xot Affect The lands herein do not affect an oi' the lands <br /> any of the Lands Described in <br />S <br />ti <br />ZI5 <br />4 <br />f <br />Mi <br />f <br />h <br />d described in SeC 1.56 (9) <br /> ec <br />on <br />( <br />)( <br />) o <br />t <br />e <br />ne <br />Land Reclamation Act. (specify <br /> affirmation) <br />MAPS AND EXHIBITS <br />With each of the five (5) copies of the application form, the applicant must submit a correspond- <br />ing set of the maps and exhibits outlined in RULE 2, as follows: <br />1. EXHIBIT A - Legal Description <br />2. EXHIBIT B - Index Map <br />3. EXHIBIT C - Pre-mining and Mining Plan Map(s) of Affected Lands <br />4. EXHIBIT D - Mining Plan <br />5. EXHIBIT E - Reclamation Plan <br />6. EXHIBIT F - Reclamation Plan Map <br />7. EXHIBIT G - Water Information <br />8. EXHIBIT H - Wildlife Information <br />9. EXHIBIT I - Soils Information <br />10. EXHIBIT J - Vegetation Information <br />11. EXHIBIT K - Climate <br />I2. EXHIBIT L - Reclamation Costs <br />13. EXHIBIT M - Compliance with Local Zoning ) See 34-32-I':5(4)(e)s 109(6)&(8) <br />I4. EXHIBIT N - Other Permits or Licenses ) See 39-32-15(4)S(4)(c) <br />I5. EXHIBIT O - Source of Legal Right to Enter ) See 39-32-12(2)(d) <br />Z6. EXHIBIT P - Owners of Record of Surface and Subsurface Rights) See 34-32-1:'2(2)(b)&(c) <br />