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<br />1 <br />1 <br />9. Source of Legal Right-to-Enter <br />1 <br />1 <br />1 <br /> <br />1 <br />1 <br />1 <br />1 <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />-z- <br />_ Notarized Statement (lease with trust) <br /> (indicate what type of proof is <br /> included in EXHIBIT 0) See <br /> Rule 34-32-112(2)(d) <br />10. Type of Mine and Substance to open pit <br /> be Mined (specify underground, <br /> open pit, quarry, etc. and <br /> substance(s) to be mined <br />11. General Location and Elevation Near Henderson, Colorado approximately 1/2 <br /> (miles dnd dlreCtiOn from I mile south on Old Briehton Road <br /> nearest town and approximate ~ 5030 <br /> site elevation <br />12. County Adams <br />13a Total Surface Acreage to be <br />Included in Permit (Rule 1.1(2)) <br />tog acres <br />13b Total Acreage of Affected Lands <br />(Rule 2.11(14)) <br />94 acres <br />14. Application Fee (see Rule 2 to <br /> determine amount, based on <br />permitted area) <br />~i,345.00 <br />15. Present Land Use (i.e., <br />agricultural, lnduStrldl, etC.) <br />pasture; hayfield <br />16. Surrounding Ldnd USeS abandoned feed lot ravel minin asture <br />17. Proposed Future Land Use (final <br />use after reclamation) <br />18. List Mining Operations Currently none <br /> In Violation of the Act. (See <br /> 34-32-120) <br />19. The Lands Herein Do Not Affect affirmative <br /> any of the Lands Described in <br /> Section 115(4)(f) of the Mined <br /> Land Reclamation Act. (specify <br /> affirmation) <br />1 <br />