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<br />s <br /> <br />~. Name of o~rner of the subsurface riohta of affected land• Bureau of Land Management <br />7. Name of owner of the surface of affected lnnd• Bureau of Land Management <br />a. Names of the holders of any recorded.easementa on the affected land: <br />(no additional owners with 200 feet) <br />e. Type of miniaa operation: X Surface Underground In-situ <br />9. Location information: The center of the area where the majority of mining will occur: <br />COUNTY: Rio Blanco <br />PRINCIPAL MERIDIAN (check one): X 6th (Colorado) 10th (New Mexico) ~ Ute <br />SECTION (write number): g 13 <br />TOWNSHIP (write number and check direction): T 4 North X South <br />RANGE (write number and check direction): R 104 East X West <br />QUARTER SECTION (check one): NE X NW SE SW <br />QUARTER/QUARTER SECTION (check one): NE NW X SE SW <br />GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the <br />approximate elevation): Thirty three miles South of The Town of Rangely <br />Elevation is 6150' <br />10. Primary future (Poet-mininc) load uee (check one): <br />Cropland(CR) Pasturelaad(PL) General Agriculture(GA) <br />X Rangeland (RL) Forestry (FR) Wildlife Habitat(WL) <br />Residential(RS) Recreation(RC)~ Industrial/Commercial(IC) <br />Developed Water Resources (WR) Solid Waste Disposal (WD) <br />11. Primary nreeent land uee (check peel: <br />Cropland(CR) ~ Pastureland(PL) General Agriculture (GA) <br />X Rangeland(RL) Forestry(FR) wildlife Habitat(WL) <br />Residential (RS) ~ Recreation (RC) Industrial/Commercial (IC) <br />Developed water Resources (WR) Mining (MN) <br />12. If this operation will use designated chemicals, or will result, or presently has acid <br />mine drainage - you cannot use this application form. You must submit either a 110d or <br />112d application form for Designated Mining Operations. In either case, you must list <br />any acidic or toxic-forming materials, exposed or disturbed as a result of the mining <br />operation, and whether the operation will result in or presently has acid mine drainage: <br />13. Description of Amendment or Conversion: <br />If you are amending or converting an existing operation, provide a brief narrative describing <br />the proposed change(s): <br />