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REGULAR (11?) PERMIT APPLICATION <br />FORM <br />-2- <br /> <br /> <br /> <br />.1. General Locatic:n and Elevation (SOUTH HALF OF THE SOUTH EAST QUARTER, SECTION 1, TOWNSHIP <br /> (miles and direction from <br />I ~10 NORTH <br />RANGE 67 WEST OF THE 6th P <br />M <br />WELD COUNTY <br /> nearest eaen a;rd a <br />proximate , , <br />, <br /> p <br /> site elevation) <br />_ _ C LORADO ELEVATION = 5565 4 MILES SOUTHEAST OF CARR, <br />,~. County <br /> Total Surface Acr~~aye to be In- <br />~~"~ eluded in Permit. (see Rule LI(2)) <br /> 3A.45 ACRES <br /> Total Acreage of Affected Lands <br />'b' (sea Rule 1.11(i~)) 36.45 ACRES <br />:.4. Application Fee (~;ee RuLE 1 to _ T C~ RNMENTAL AGENCY WAIVER <br /> determine amount, based on <br /> permitted area) <br />:~. Present Land usa (i.e., agri- GRAVEL BREAK IN PRAIRIE GRASSLAND <br /> cultural, indusrrial, etc.) EAST 16,5*_ ACRES PREVIO USLY MINED) <br />.~ Surrounding Land ils es <br />% PRAIRIE GRASSLAND, SOME CULTIVATION <br /> <br />... <br />Proposed Future Lard Use (final _ <br /> use after recian,~tlon) PRAIRIE GRASSLAND <br />'9. List alining Operations Currently _ <br /> In Violation of the .4ct. (see <br /> <br />' 34-32-110) <br /> The Lands Rerei:i Dn Not Affect TO THE BEST OF MY KNOWLEDGE, NONE OF THE LANDS SO <br /> any of the Lands Described in ESCRIBED ARE INCLUDED IN THIS APPLICATION <br />' <br /> Section I15(4)(:~l of the Pfined , <br /> - <br /> i.an~ Recla:.~ti er. ;c t. (specify <br /> ci i f.:"ma Cl On) <br />MA FS AND EXFIIBITS <br />. •~ir each of the fi vc (5) copies of the appl_ca ti on form, the applicant ,must submit a corr,>;rnr.~i- <br />,. se[ of the maps and exhibits outlined in RULE 2, as follows: <br /> E:fNIBiT A - 7,e y.. i Description <br />_ . E.W IDIT 8 - In dr--,: Flap <br />i. E"nEI3IT C - Pre-mi r.i nq and Mining Flan Map(s) of lffected Lands <br /> EKh"i3I^ D - hfi ni nq Plan <br />.. E:i.Y oIT £ - Reci~v r. ~; ti on Plan <br /> E.KH ~D_TT F - Recl.~ir~ti on Plan Map <br /> E:GY .B IT G - WatcC Information <br /> E:~:Y ZD IT S' - {Jil aii.e Information <br /> '~'!IDIT I - Soils _Tnformation <br /> 3 ;; ~i 37T .T - Vege ra t.ron Informs ti on <br />~. .=;:ifI3IT K - Cli:rt:t~ <br /> 37:PIDIT L - Rec!ana ti on Costs <br /> <br />'. .4):F~37T <br />ER97DIT N - <br />N - Comrli.xice with Loea1 Zoning <br />Ocher ''ermits or Licerses ) <br />) <br />~. .: '~:h"SHIT O - So ur~~r. or Legal Right to Enter ) <br /> E~tfIB_TT F - LlJner_ of Record of Surface and S ubsur_f~ce Rio^ts) <br />CO. <br />See 34-32-115(4)(^)610?iii) ~. (.:: <br />See 34-32-115(4)s(4)(c) <br />See 34-32-I12(7)(d) <br />See 34-32-112(2)(b)s(c) <br />3 <br />