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i III IIIIIIIIIIIIIIII <br />"~ ~~A~ <br />P.PR ^ ~ 1908 <br />REGULAR (112) PERMIT <br />APPLICATION FORM <br />_„ <br />w:. ~`~_ ._ 's .R:i ~: is <br />f~ECLNr~?Ar~ON DiVi:-:!Ot~ <br />This form contains two mayor parts: (1) General Operation Information and (2) Exhibits <br />A-P. When you submit your application, be sure to include four ski ned copies of the <br />General Operation Information, four copies of Exhibits A-P, and a c e k for the <br />application fee described under (4) below. To expedite processing, please provide the <br />information in the format and order described in this form. <br />_________=______________________ ___________________________~_~_C1_J__~ _ ~~__2.221~=== loth <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided. all information described below. <br />1. Applicant/Operator Name: _rnai rrat <br />2. Operation Name (Pit, mine or site name): <br />3. Application type: Regular (112) Permit Operation. <br />4. Applicat:ton Fee for Permitted ACreage* ~ Sao permitted <br />acres. <br />(E50.00 + =15.00/acre, 1st. 50 acres; <br />f10.00/acre, 2nd. 50 acres; E5.00/acre, 3rd. 50 acres; <br />11.00/ac:re, aqy additional acreage; maximum fee of <br />E2,000.00).* <br />Note permitted acreage and application fee and <br />attach a check for this amount when you file. u~,nnn application fee. <br />5. Substance(s) to be mined (e. g., gold/silver/gravel): c~na <br />6. Owner=(s) of Substance to be Mined <br />(cheek applicable box(s)): ^ Private ®c State O Federal p Indian <br />7. Owner(s) of Record of Affected Land <br />(cheek applicable box(s)): ^ Private ~tState ^ federal ^ Indian <br />8. Type of Mining Operation <br />(check applicable box(s)): ~ Surface ^ Underground O In-situ <br />9. Location Information. The center of the area where the majority of mining will <br />occur lies in: <br />COUNTY: <br />PR]:NCIPLE R D N c ec one 6th (Colorado) ^ 10th (New Mexico) ^ Ute <br />TOWNSHIP (write number and check ~rection): T 5 ^ North f] South <br />RANGE (write number and check direction): R 65 ^ East ic~C West <br />SE(:TION (write number): S <br />QUARTER SECTION (check one): O~ ^ NW Q SE O SW <br />QUARTER/QUARTER SECTION (check one): O NE ^ NW ^ SE ^ SW <br />GENERAL DESCRIPTION: <br />(miles and direction Alnna c~ai rrPPk hetwPen F.. Ouincv Ave, and <br />from nearest town and <br />approximate elevation) the Arapahoe-E1hPrt County line. 5900'. elev. <br />* If the operrator is a unit of State or county government, an application fee is not <br />required. A fraction of an acre must be counted as one acre for fee calculation. <br />