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Ill iiillllillllllll M <br />~~.,Li'~IEL~ <br />TWO-ACRE LIMITED IMPACT OPERATION (110(1) ) Mqy 14 1991 <br />RECLAMATION PERMIT <br />APPLICATION FORM <br />?Sided sand <br />4E~'.c.'~ ~tiuu Division <br />The application fora Two-Acre Limited Impact Operation Reclamation Permit shall contain <br />three major parts: (1) the application form, (2) Exhibits A-H, and (3) the application <br />fee. When you submit your application, be sure to include two (2) signed copies of the <br />application form, two (2) copies of Exhibits A-H, and a check for a app ication fee <br />described under (3) below. To expedite processing, please provide the information in <br />the format and order described in this form. <br />______________________________________________m ~1==5-====1s 5?_3===SyS <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />------- ---------------------------------- <br />1. Applicant/operator name <br />Indian Creek Mining Corporation <br />1.1 Type of organization (Corporation, partnership, etc.) <br />2. Operation Name (pit, mine or site name): Proffitt <br />Corporation <br />2.1 IRS Tax ID No. or Social Sea rity No.: <br />3. Application fee for permitted acreage: <br />(525 + S10/acre)* <br />Note permitted acreage and application fee and <br />attach a check for this amount when you file. <br />4. Substance(s) to be mined (e.g., gold/silver): <br />$45.00 application fee <br />Gold/Silver <br />5. Name, address, and phone number of the owner of the surface of the affected land: <br />Lewis J. Allen Estate of Lo an Allen - Berniece Macklin P.O. Box 13 <br />C 8 201-01 - 719 539-6606. <br />6. Name of owner of subsurface rights of affected lands: Lewis J. Allen. Estate of ooaaen <br />7. Type of mining operation: _ Surface XUndergrounu _ In-situ <br />8. Location Information. The center of the area where the majority of mining will <br />occur 1 i es i n: <br />COUNTY: Saguache <br />PRINCIPAL MERIDIAN (check one): 6th (Colorado) X <br />TOWNSHIP (write number and check direction): T 47 -' <br />RANG'c (write number and check direction): R -T <br />SECTION (write number): S T <br />QUARTER SECTION (check one): X-NE- <br />QUARTER/QUARTER SECTION (check one): - NE <br />GENERAL DESCRIPTION: <br />10th (New Mexico) Ute <br />X North South- <br />~ East - 'nest <br />_ NW SE _ SW <br />NW X SE SW <br />(miles and direction 5 miles NW of Bonanza, CO <br />from nearest town and <br />approximate elevation) 11,800 elevation <br />Less than 2 acres permitted acres <br />* A fraction of an acre mist be counted as one acre for fee calculation. If the <br />operator is a unit of state or county government, an application fee is not required <br />