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~`~ B -~yy- ~ IIIIIIIIIIIIIIIIIII <br />Sf~K ~ ~ r 999 <br />~~~~~v~~ <br />LIMITED IMPACT OPERATION (110(2 ~I~E ~ LSPdD <br />) ) C'sECLF+MATIOiV i71 dl.~lC~N <br />APPLICATION FORM <br />The Application for a Limited Impact Operation Reclamation Permit contains three major <br />parts: (1) the Application Form, (2) the Application Exhibits A-F, and (3) the <br />application fee. When you submit your Application, be sure to include two s~~i~99ned copies <br />of the Application Form, two copies of Exhibits A-F, and a check for the appp i~cafion fee <br />described under (4) below. To expedite processing, please provide the information in <br />the format and order described in this form. - - -~y~ _~~_/ , ~~,~~~ <br />GENERAL OPERATION INFORMATION ~ /~ 5 c ~ ~ <br />Type cr print clearly, in the space provided, all information described below. <br />1. Applicant/Operator Name: Colorado Lien Company <br />2. Operation Name (Pit, mine or site name): weaver Ouarry <br />3. Application type: Limited Impact Operation (110). <br />4. Application Fee for Permitted Ac reage* permitted acres. <br />(E10 x (affected acres) + 525.00).* <br />Note permitted acreage and application fee and <br />attach a check for this amount when you file. SI25.0o application fee. <br />5. Substance(s) to be mined (e.g., gold/silver/gravel): <br />6. Owners (s) of Substance to be Mined <br />(check applicable box (s )): x Private _ State ~ Federal _ Indian <br />7. Owner(s) of Record of Affected Land <br />(check applicable box (s )): x Private State Federal Indian <br />8. Type of Mining Operation <br />(check applicable box(s)): ~ Surface _ Underground _ In-situ <br />9. Location Information. The center of the area where the majority of mining wil l <br />occur lies in: <br />CI]UNTY: Larimer <br />PRINCIPLE ER c ec one 6th (Colorado) 10th (New Mexico) Ute <br />TOWNSHIP (write number and check direction): T 9 x North South <br />RAIJGE (write number and check direction): R 69 East x West <br />SECTION (write number}: S 7 <br />QIJARTER SECTION (check one): -A'E- NW ~ SE _ SW <br />QUARTER/QUARTER SECTION (check one): _ NE _ NW ~ SE _ SIJ <br />GENERAL DESCRIPTION: <br />(tulles and direction 8.5 miles (crow flies) WNW of We1linRton; <br />from nearest town and 9 miles (crow flies) N of Laporte <br />a~~proximate elevation) elevation aouroximately 6000 feet <br />* If the operator is a unit of State or county government, an application fee is not <br />required. A fraction of an acre must be counted as one acre for fee calculation. <br />