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-3- <br />10. Location information: The center of the area where the majority of mining will occur lies in: <br />COUNTY: '~i°~/t°~' <br />PRINCIPAL MERIDIAN (check one): J~6th (Colorado) 10th (New Mexico) _ Ute <br />SECTION (write number): S <br />TOWNSIEP (write nmmber and check direction): T ~ North / South <br />RANGE (write number and check direction): R `~ ~ East / West <br />QUARTER SECTION (check one): _ NE / NW _ SE _ SW <br />QUARCERIQUARTER SECTION (check one): J/ NE _ NW _ SE _ SW <br />GENERAL DESCRIPTION (miles and direction fmm nearest town and approximate elevation): <br />11. Primary future (Post-minims) land use (check one): <br />Cropland(CR) _ Fastureland(PL) Sieneral Agricultare(GA) <br />_ Rangeland(RL) Forestry(F'R} r/Wildlife Habifat(WL) <br />_ Residential(RS) _ Recreation(RC) IndpshiaUCommerciat(IC) <br />Developed Water Resources(WR) _ Solid Was[e Disposal(WD) <br />12. Primary present land nse (check one): <br />_ Cropland(CR) Pastureland(PL) _ General Agriculture(GA) <br />_ Rangeland(ItL) _ Forestry(FR) _ Wildlife Habitat(WL) <br />_ Residential(RS) Recrealion(RC} IndustriaUCommercial(IC) <br />Developed Water Resources(WR) ~/lvfining(MI~ <br />13. If this operation wi71 use designated chemicals, or wilt result, or presently has acid mine drainage -you cannot use this <br />application form You must submit a either a ] lOd or 112d application form for Desigoated Mining Operations. In either <br />case, you must list any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and <br />whether tjae operation will result in of presently has acid mine drainage: <br />14. Deseription of Conversion: >f you are com~erting an existing operation, provide a brief narrative descn'bing the proposed <br />I5. Mans & Exhibits: Submit two (2) wmplele, unbound espies of the following application exhibits: <br />6.3.1 EXHIBFI' A -Legal De~rip@on and Location Map <br />6.3.2 EICT-IIBIT B -Site Description <br />6.3.3 EXfiTBTT C - MiIIing Plan <br />6:3.4 EDIT D -Reclamation Plan <br />6.3.5 EXIIIBTT E -Map <br />6.3.6 EXIIIBIT F - List of Other Permits and Licenses Required <br />6.3.7 EXIIIBIT G -Source of Legal Right-to-Enter <br />6.3.8 EXEIlBIT Ii -Municipalities Within aTwo-mile Radius <br />6.3.9 EXIIIBIT I -Proof of Filing with County Clerk <br />6.3.10 EXFIIBTT J -Proof of Mailing Notices of Permit Application <br />6.4.19 EXIIIBff S - (as required) <br />6.5 Geotechnical Stability Exhibit (as required) <br />