PERMFILE120820

• Permit No: M1987078
• IBM Index Class Name: Permit File
• Doc Date: 5/5/1987
• Doc Name: LIMITED IMPACT OPERATION 110 APPLICATION FORM
• Media Type: D
• Archive: No

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LIMITED IMPACT OPERATION (110~EC`A ~NEp ~,qNp
APPLICATION FORM NATION DIVISION
This form contains two major parts: (1) General Operation Information and (2) Exhibits
A-G. When you submit your application, be sure to include two signed copies of the
General Operation Information, two copies of Exhibits A-G, and a c deck for the
' application fee describe! ender (4) below. To expedite processing, please provide the
information in the format and order described in this form. _ _
GENERAL OPERATICN INFORMATION
' Type ~~r print clearly, in the space provided, all information described below.
1. Applicant/Operator Name: City of Lamar, a Municipal Corporation
2. Opera+;~^n Name (Pit, mine or site name): Lamar Industrial Park Gravel Plt
3. Application type: Limited Impact Operation (110).
4. Application Fee for Permitted Acreage* q,9P3 permitted acres.
(510 x (affected acres) + 525.00).*
Note l~ernitted acreage and application fee and
attache a check for this amount when you file. $125.00 application fee.
:;. Substance(s) io be mined (e. g., gold/silver/gravel): s~„d ++d .rayei_ __
5 ^•:~+er•:;(s) of Substance to re Mined X Mrnici~l
(cf~eck applicable box(s)): ^ Private ^ State ^ Federal ^ Indian
7. Owner(s) of Recer" of Affoeted Land X Municipal
(cF~eck applicable box(s)): ^ Private ^ State ^ Federal ^ Indian
8. Type cf dining Operation
(cher~ applicable h~;;;_11: ~ Surface c7 Underground ^ In-situ
9. Location Information. T1~e center of the area where the majority of mining will
occur lies in:
COUNTY: Provers Count
PRINCIPLE MERIDIAN check one ® 6th (Colorado) ^ 10th (New Mexico)^ Ute
TOWNSHIP (write number and check direction): T 22 ^ North ® South
RANGE (write number and check direction): R ~- ^ East ® West
'SECTION (write number): S ~Q

QUARTER SECTION (check
one): ~
^-NE ^
NtJ ^ SE
® SW
QUARTER/QUARTER SECTION (check one): ^ NE ^ NlJ ® SE ® SW
GENERAL DESCRIPTION:
(miles and direction Location is xithin the Cit v Limits of the
from nearest town and
approximate elevation) City of Lamar. Elevation is 'j606.
* Ir the operator is a unit of State or county government, an application fee is not
required. A fraction of an acre must be counted as onP acr~.for fee calculate^^.
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