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~ q . o vy ~. <br />~{~ ~ ~~~~ ~ -,~ JUN 1T 1991 <br />LIMITED IMPACT OPERATION (110(2)) <br />APPLICATION FORM ~~~T: <br />The Application for a Limited Impact Operation Reclamation Permit contains three major <br />parts: (1) the Application Form, (2) the Application Exhibits A-F, and (3) the <br />application fee. When you submit your Application, be sure to include two si~ne~d copies <br />of the Application Form, two copies of Exhibits A-F, and a check for the app-Ticafion fee <br />described under (4) 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 />1. Applicant/Operator Name: Kit Carson Councy <br />2. Operation Name (Pit, mine or site name): _Heintaes Pit_ __ <br />3. Application type: Limited Impact Operation (110). <br />4. Application Fee for Permitted Acreage* 9.9 -permitted acres. <br />(E10 x (affected acres) + b25.00).* <br />Note permitted acreage and application fee and <br />attach a check for this amount when you file. N/A application fee. <br />5. Substance(s) to be mined (e.g., gold/silver/gravel): sand b Gravel <br />6. Owners (s) of Substance to be Mined <br />(check applicable box(s)): x Private State Federal Indian <br />7. Owner(s) of Record of Affected Land <br />(check applicable box(s)): x Private State Federal Indian <br />8. Type of Mining Operation <br />(check applicable box(s)): x Surface _ Underground _ In-situ <br />9. Location Information. The center of the area where the majority of mining will <br />occur lies in: <br />COUNTY: Che enne <br />~ <br />PRINCIPLE ER c ecc one <br />~th (Colorado) 10th (New Mexico) Ute <br />TOWNSHIP (write number and check direction): T 12 North x South <br />RANGE (write number and check direction): R 43 _ <br />East x West <br />SECTION (write number): S 1 _ <br />QUARTER SECTION (check one): x -A~ NW SE SW <br />QUARTER/QUARTER SECTION (check one): NE _ <br />_ <br />NW g SE SW <br />GENERAL DESCRIPTION: <br />(m71es and dlrectl0n From Arapahoe 3/4 Mi East, 13 1/2 Mi North <br />from nearest town and <br />approximate elevation) on County Rd 54. Elev. = 4136 <br />* If the operator 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 />