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'~~+:q JTI!' 9 - - ~ R~~EI~/tp ~ III I II I II I II IIII III r 2 ) FEB 0 3 1995 HYYL1t;3iIION FORM ~,,(,~Qr pc~~nnV CHECK ONfi: R New Application (Rule 1.9.5) Amendic~~ F~ZY'G'd~~i~~YV(RU7~e 1.101 Conversion Application (Rule 1.11) Permit No. M- (provide for amendments and conversions of existing permits) The application for a Regular Operation Reclamation Permit contains three major parts: (1) the application form; (2) Exhibits A-S and Geotechnical Stability Exhibit; and, (3) the application fee. When you submit your application, be sure to include one (1) signed and notarized original and four (4) copies of the application form, five IS) copies of Hxhibite A-R and any required sections of Exhibit S and the Geotechnical Stability Exhibit, and a check for the application fee described under Section (16) on Page 3. Hxhibite should not be bound or in a 3-ring binder; maps should be folded to B 1(2^ x 11^ or 8 1/2^ X 14^ size. To e~medite processing, please provide the information in the format and order~d~1escribed in this form. ~'/ 95! t7~~ ," ~ 7~ ,~~/~ ------------------------- GENHRAL OPHRATION INFORMATION Type or print clearly, in the apace provided, all information described below. 1. Applicant/operator or company name (name to be used on permit): Frenont Pavin R_ Redi-Mix, Inc. 1.1 Type of organization (corporation, partnership, etc.): Corporation 1.2 I.R.S. Tax ID No. or Social Security Number: 2. Operation name (pit, mine or site name): Florence Pit 3. Permi tted acreage (new or existing site) 14.4± permitted acres 3.1 Change in acreage (+ or -) acres 3.2 Total acreage in Permit area ~- acres 4. Fees: 4.1 New Application 51.875.00 application fee 4.2 New Quarry Application S2,325.00 quarry application 4.3 Milling Application (Non-DMO) S3.100.00 milling application 4.4 Amendment Fee 51.550.00 amendment fee 4.5 Conversion to 112 operation (set by statu te) S1, 500.00 conversion fee 5. Primary co~¢mioditie(s) to be mined: sand and gravel 6. Name of owner of surface of affected land: Refer to Exhibit P 7. Name of owner of subsurface rights of affected land: Refer to Exhibit P If 2 or more owners, refer to Exhibit O. B. Type of mining operation: X Surface IInderground In-situ 9. Location information: the center of the area where the majority of mining will occur lies in: COIIN1^[: Fremont PRINCIPAL MERIDIAN (check one): X 6th (Colorado) 10th (New Mexico) _ IIte SECTION (write number): S T6 TOWNSHIP (write number and check direction): T -ItT- _ North X South RANGE (write number and check direction): R ~ East ARTHR SECTION (check one): _ _ ]L NE NW SH SW QLII\RTSR/QIIARTHR SECTION (check one): NH ~ NW SE SW GHNHRAL DESCRIPTION (miles and direction from nearest town and approximate elevation): AnRrosinately 0.25 m~1P pnrt5 n` Flnranra- A~proxir^ately 5,250 ft, elevation. ®RIGI~fAL