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<br />-2- <br /> <br />3. Address and Phone Number of Phillips County Road Dist #1 <br /> Local Of fices 53037 Rd 37 <br />~ Amherst, CO 80721 <br />4. Addre!;s and Phone Number of Phillips County Commissioners <br /> General Offices Phillips County Courthouse <br /> 221 S. Interocean, Holyoke, CO 80734 854-2454 <br />5. Name z.nd Phone Number of Person Randy Schafer <br /> Staff Me mbers Should Contact Phillips County Planner <br /> Phillips County Courthouse, Holyoke, CO 854-3778 <br />6. Owner(s) of Record of Affected Land <br /> (surface area) (If more than 2, list below) <br /> Nancy Jo Kennedy <br />7. Owner(s) of Substance to be Mined <br /> (If more than 2, list below) <br /> Nancy Jo Kennedy <br />8. Source of Legal Right-To-Enter <br />(Indicate what type of proof is <br />included in EXHIBIT G -lease, Notarized Agreement <br />deed, notarized letter, etc.) <br />9. Type o•F Mine and Substance to be Mined <br />(Spec i•°y underground, open pit, <br />quarry., etc. & substance(s) to <br />be minitd) Sand and Gravel <br />16. Genera". Location and Elevation <br />(Miles & direction from nearest <br />town & approximate site elevation) <br />7 Miles East <br />2 Miles South and 3/4 E of Holyoke <br />Approximate site elevation 3630 <br />11. County <br />Phillips <br />12. Acreage of Affected Lands <br />(Total surface acreage to be <br />included in permit) 9 9 <br />13. Application Fee (See applicable <br />Rule to determine amount) Waived by legislature for counties <br />