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RECEIVED <br /> LIMITED IMPACT OPERATION (110(2) ) NOV 2 7 1991 <br /> RECLAMATION PERMIT <br /> APPLICATION FORM Reo"nat O land <br /> aion Divisi <br /> The application for a Limited Impact Operation Reclamation Permit contains �iree 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 two (2) signed originals of the <br /> ' application form, two (2) copies of Exhibits A-J , and a check for the application fee <br /> described under (3) below. To expedite processing, please provide the information in <br /> the format and order described in this form. <br /> GENERAL OPERATION INFORMATION - <br /> Type or print clearly, in the space provided, all information described below. <br /> t1 . Applicant/operator name: Ti c. <br /> *1 .1 Type of organization (corporation, partnership, etc. ): Corporation <br /> ' 2. Operation name (pit, mine or site name): Tiger Timber Expansion Site <br /> ' 2.1 I.R.S. Tax ID No. or Social Security No.: 74--2295203 <br /> 3. Application fee for permitted acreage* 5.6 permitted acres <br /> ' (E25. .00 + 10/acre)* <br /> Note permitted acreage and application fee and <br /> attach a check for this amount when you file. $875.00 application fee <br /> ' 4. Substance(s) to be mined (e.g. , gravel/gold/borrow): Gravel <br /> 5. Name of owner of surface of affected land: Larry L. Laughc.ey <br /> 6. Name of owner of subsurface rights of affected land: Larry L. Laughrey <br /> ' 7. Type of mining operation: x Surface _ Underground _ In-situ <br /> 8. Location information. The center of the area where the majority of mining will <br /> occur lies in: <br /> ' COUNTY: Teller <br /> PRINCIPAL MERIDIAN (check one): x 6th (Colorado) loth (New Mexico) Ute <br /> ' TOWNSHIP (write number and check dire`ction): T 13 i North x -South <br /> RANGE (write number and check direction): R 71 , East x West <br /> SECTION (write number): S 2 <br /> ' QUARTER SECTION (check one): — Rr — NW x SE — SW <br /> QUARTER/QUARTER SECTION (check one): . x NE r NW SE SW <br /> GENERAL DESCRIPTION: <br /> (miles and direction One quarter mile North of Florissant <br /> from nearest town and <br /> approximate elevation) 8200 M.S.L. <br /> ' * A fraction of an acre mist be counted as one acre for fee calculation. If the <br /> operator is a unit of state or county government, an application fee is not required. <br />