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<br />~~ III IIIIIIIIIIIII III ~ `~~~ d °y ~'~ <br />LIMITED Inrn~l vr~9ic9nil~n ii10(2)) N ~ lyy, <br />RECLAMATION PERMIT <br />APPLICATION FORM ivuned Land <br />CHECK ONE: xx New Application (Rule 3.2) Ame Rc~meir~t App}icatio~iD(Rule 1.8) <br />Conversion App 1'i cation (Rule 1.10) <br />The application far a Limited Impact Operation Reclamation Permit contains three major <br />parts: (1) the application form; (2) Exhibits A-J; and, (3) the application fee. When <br />you submit your application, be sure to include one (1) signed original and one (1) copy <br />of the application form, two (2) copies of Exhibits A-J, and a check for the application <br />fee described under (3) below. To expedite processing, please pr vide the information <br />in the format and order described in this. form. M ~^,( <br />v vevvveee:evvevveeeeveeeveeeveeveeeeeeeeeoeveoovovveaved= ~~vvv~eea=ovoovveeeee=eves=e=- <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ail information described below. <br />eee»»>=»eeevveavveaeeeeveeevveeeaoveeaeeeeeeeveeeveeeeeevee»====__'==°=e====eeeev==== <br />1. Applicant/operator name: cITY of MONTE VISTA <br />1.1 Type of organization (corporation, partnership, etC.): GOVERNMENT <br />2. Operation name (pit, mine or site name) <br />LAGOON PIT <br />2.1 I.R.S. Tax ID No. or Social Security No.: aa-6ooo6l0 <br />3. Permitted acreage I~ permitted acres <br />3.1 Application Fee (New Application Only) 5875.00 application fee <br />4. Substance(s) to be mined (e.g., gravel/gold/borrow): <br />5. Name of owner of surface of affected land: CITY of <br />6. Name of owner of subsurface rights of affected land: <br />7. Type of mining operation: x Surface _ Underground <br />8. Location information. The center of the area where th <br />occur lies in: <br />COUNTY: RIO GRANDE <br />GRAVEL <br />MONTE VISTA <br />CITY OF MONTE VISTA <br />_ In-situ <br />e majority of mining will <br />PRINCIPAL MERIDIAN (check one): 6th (Colorado) ~ 10th (New Mexico) Ute <br />TOWNSHIP (write number and check direction): T 39 x North South <br />RANGE (write number and check direction): R s x East _ West <br />SECTION (write number): S 3z <br />QUARTER SECTION (check one): x NE NW SE SW <br />QUARTER/QUARTER SECTION (check one): NE NW _ SE x SW <br />GENERAL DESCRIPTION: _ _ <br />(miles and direction ONE MILE NORTHEAST OF MONTE VISTA <br />from nearest town and <br />approximate elevation) 7666 <br />