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<br />-2- <br />3. Address and Phone Number of 6322 S. College Ave. <br />Local Offices Ft. Collins, CO 80525 (303)226-4111 <br />4. Address and Phone Number of 6322 S. College Ave. <br />General Offices Ft. Collins, CO 80525 <br />(303)226-4111 <br />5. Name and Phone Number of Person Doug Kehn <br />Staff Members Should Contact (303)226-4111 <br />6. Owner(s) of Record of Affected Land "The Dollerschell Girls" <br />(surface area) (If more than 2, list below) 7 Mrs. Rosella Schure <br />1. Owners} of Substance to be Mined "The Dollerschell Girls" <br />(If more than 2, list below) ~ Mrs. Rosella Schure <br />B. Source of Legal Right-To-Enter <br />(Indicate what type of proof is <br />included in EXHIBIT G - Tease, Per attached lease <br />deed, notarized letter, etc.) <br />9. Type of Mine and Substance to be Mined <br />(Specify underground, open pit, Sand and Gravel <br />quarry, etc. & substance(s) to <br />be mined) <br />Approximately 5 miles west of Sterling, CO on <br />10. General Location and Elevation Highway 14. Two miles north of Highway 14 to <br />(Miles & direction from nearest County Road 32. East on Cty Rd. 32 approx. } <br />town & approximate Site elevation) miles to entrance. Approx. site elevation is 4100- <br />4~Ilh Fr dhQye 9A0.1GYG1 - <br />11. County <br />12. Acreage of Affected Lands <br />(Total surface acreage to be <br />included in permit) <br />13. Application Fee (See applicable <br />Rule to determine amount) <br /> <br />Logan <br />Size - 480 x 900 = 9.42 acres <br />($25.00 plus $10.00/acre) <br />$25.00 + $99.20 $124.20 <br />i <br />I _. <br /> <br />