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<br />-2- <br /> <br />3. Address and ?Bone i~umoer of - Grand County Courthouse <br />Local Uffices ~ Ilot Sulphur Springs, CO. 30451 <br />~~G_~~n~ <br />4. Adoress and Phone Wumber of <br />General Offices <br />Same As Above <br />5. Yame and Plione ilwnoer of Person Tinothy L. Deliitt-flepartment of Develop- <br />Staff Members Should Contact Went <br />- 725-3347 ext. 243 <br />ti. Owner(s) of Record of Afrected Land _ <br />(surface area) (If more than 2, list below) Gureau of Land ~;anagement <br />7. Uwner(s) of Substance to oe Mined <br />(If more than 2, list belo~,i) <br />d. Source of Legal Right-To-Enter <br />(Indicate what type of proof is <br />included in EXNItrIT G - lease, <br />deed, notarized letter, etc.) <br />Bureau of Land tlanagement <br />(See Cover Letter) <br />9. Type of t•iine and Substance to be I-tined <br />(Specify underyround, open pit, .- <br />quarry, etc. & substance(s) to <br />oe mined) <br />Sand and Gravel Open Pit <br />lU. general Location and Elevation <br />(Miles & direction from nearest <br />town & approximate site elevation) <br />11. County <br />12. Acreage of Affected Lands <br />(Total surface acreage to be <br />included in pennit) <br />13. Application Fee (See applicable <br />Mule to detennine amount) <br />8 r:iiles lest of liot Sulphur and <br />7 rules East of I;renmlin9, Colorado <br />on Grand County Road ;`201 <br />Grand <br />9.Gu acres, more or less <br />waiver requested for application fee <br /> <br /> <br />