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.; / ~ <br />II I I II I II I II IIII III ,,~ ~ ~; ~ ~ <br />~~ <br />Auk J ig89 <br />LIMITED IMPACT OPERATION (110(2)) <br />APPLICATION FOfU4 RE tii~NEJ~ LA~^yC) <br />ClAh1A1-1CPd <br />The Applicat~ton fora Limited Impact Operation Reclamation Permit contain~~FS~`Igajor <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 siyned~copies <br />of the Appli~:ation Form. two copies of Exhibits A-F, and a check for the apT c Sion fee <br />described under (4) below. To expedite processing, please provide the information in <br />the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/Operator Name: Fremont County Board r <br />2. Operation Name (Pit, mine or site name): nak r, <br />3. Application type: Limited Impact Operation (110). <br />4. Application Fee for Permitted Acreage* 9-2 ± permitted acres. <br />(E10 x (affected acres) + E25.00).* <br />Note permitted acreage and application fee and <br />attach a check for this amount when you file. to/n application fee. <br />5. Substance(s) to be mined (e.g., gold/silver/gravel): 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 )): ~ 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 will <br />occur lies in: <br />COUNTY: Fremont <br />PRINCIPLE E A c ec one ~ 6th (Colorado) ~" <br />TOWNSHIP (write number and check direction): T ~_ <br />RANGE (write number and check direction): R L <br />SECTION (write number): S 23 <br />QUARTER SECTION (check one): <br />QUARTER/QUARTER SECTION (check one): ~ NE <br />GENERAL DESCRIPTION: <br />10th (New Mexico) Ute <br />North ~ South <br />_ East ~ West <br />NW SE ] SW <br />_ NW _ SE ~( SW <br />(miles and direction 13.25 miles south of Canon city <br />fran nearest town and <br />approximate elevation) 7740 tt. <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 />