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1111111111111111111 ~~~~~~~ 99g AUG 71989 TWO ACRE LIMITED IMPACT OPERAIiun (110(1)) APPLICATION FORM MINED LAPdD t3ECLAMA~~Ora r7r~rl.~rnra The Application for a Two Acre Limited Impact Operation Reclamation Permit sha contain four major parts: (1) this Application Form, (2) Application Exhibits A-F, (3) an application fee, and (4) a financia] warranty. When you submit your Application, be sure to include two signed copies of the Application Form, two copies of Application Exhibits A-F, a checcl~or the application fee described under (4) below, and a financial warranty for the required amount. To expedite processing, please provide the information in the format and order described in this form. ----------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------- GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, all information described below. 1. Applicant/Operator Name: sTaNC.EY C. ,TOtvEs 2. Operation Name (pit, mine or site name): coLORr.DO ALABASTER supPLY 3. Application Type: Two Acre Limited Impact Operation (110(1)). 4. Application Fee for Permitted Acreage: Indicate permitted acreage and application 1.99 permitted acres. fee, (i;10 x (affected acres) + E25)* and attach a check for this amount when you file your application. $95.00 application fee. 5. Substance(s) to be Mined (e. g., gold/silver): ALABASTER 6. Owner(s) of Substance(s) to be Mined (check applicable box (s )): _ Private x State _ Federal _ Indian 7. Owner(s) of Record of Affected Lands (check applicable box (s )): ` Private x State _ Federal _ Indian 8. Type of tAining Operation ;check. applicable bor.(<_)): x 9~rface _ Underground _ In-situ 9. Location Information. The center of the area where the majority of mining will occur lies in: COUNTY: LARIMER PRINCIPE M RID AN c ec one): x 6th (Colorado) 10th (New Mexico) Ute TOWNSHIP (write number and check 3irection): _ T 11 x North South RANGE (write number and check direction): R 70 East X West SECTION (write number); S 36 QUARTER SECTION (check one): x ~ NW SE SW QUARTER/QUARTER SECTION (check one): x NE _ NW _ SE _ SW GENERAL DESCRIPTION: (miles and direction from nearest Coming from Fort Collins, it is aonrox. town and approximate elevation) 25 miles northwest. Elevation 6120-6250 •f t. * A fraction of an acre must be counted as one acre for fee calculation. If the operator is a unit of state or county government, an application fee is not required.