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~,r~~ ~• <br />~ ~ Q~CEIvFn <br />LffiTED IMPACT OPfiRATZON (110(2)) FEB 0 1 1996 <br />RECLAMATION PERMIT <br />APPLICATION FORM Division of A'1rt)erals 8 Geu~~y., <br />CHEC]C ONE: X Nea Application (Rule 1.4) _ Amendment Application (C.R.S. 34-32.5-110) <br />_ Conversion Application (Ytule 1.11) <br />Permit # M- - (provide for amendments and conversions of <br />existing permits) <br />The application fora Limited Impact Mining Operation Reclamation Permit contains three major <br />parts: (1) the application form; (2) Exhibits A-J, Addendum 1, any sections of Exhibit S and <br />GeOteChII2 Cal Stability ^rfiibit, as required by the Office, and outlined is Rules 6.1, 6.2, <br />6.3, 6.4.19 and 6.5; aid (3) the application fee. When you submit your application, be sure <br />to include one (1) sinned gad notarized original and one (1) copy of the application form, <br />two S2) copies of fixhibits A-J, appropriate sections of 6.4.19 Exhibit S and 6.5 <br />(Geotechnical Stability Exhibit), as required, and a check for the application fee described <br />under (4) below. fixhibits should not be bound or is a 3-ring binder; maps should be folded <br />to 8 1/2" X 11" or B 1/2" X 14" size. To expedite processing, please provide the information <br />in the format gad order described in this form. <br />- ---------- - --------- <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/operator or company name (name to be used on permit): <br /> 1.1 Type of organization (corporation, partnership, etc.): County Gvmt. <br /> 1.2 I.R.S. Tax ID No. or Social Security Number: <br />2. Operation name (pit, mine or site name): Cimla Hiehwav Pit <br />3. Permitted aczeage (aer or existing site): b Acres permitted acres <br /> 3.1 Change is acreage (+ or -) acres <br /> Total Acreage in Permit Area fi A c acres <br />4. Fees: <br /> 4.1 New Application Sa-75.II0- application fee <br /> Amendment Fee (C.R.S. 34-32.5-125(II)) °°`~,~~- application fee <br /> 4.2 Conversion Fee (from li0d to 110 875.00 conversion fee (Rule 1.11.2(2)) <br />5. Primary coamoditie(s) to be mined: Dirt ' <br />6. Name of oaaer of the subsurface rights of affected land: Vivian Shelton (Hendricks) <br />7. Name of ormer of the surface of affected land: Vivian Shelton <br />8. Type of mining operation: X Surface Underground In-situ <br />9. Location information. The center of the area where the majority of mining sill <br /> occur lies in: <br />COONTY: El Paso <br />PRINCIPAL MERIDIAN (check one): ~- 6th (Colorado) 10th (New Mexico) IIte <br />SECTION (write number) : S 1Q_ <br />1'OWNSFIIP (write number and check direction): T ~_ North X South <br />RANGfi (write number and check direction): R 1j.Q,_ _~ East X west <br />QIIARTER SECTION (check one): NE NW ~ SE SW <br />QUARTfiR/QUARTER SECTION (check one): NE NW ~ SE SW <br />GENERAL DESCRIPTION: (the number of miles and direction from est town and <br />the approximate elevation) 5 miles East Southeast of Ramah Colorado, Elevation .5500 ~'~', <br />