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-Z' L Loyd SKalcl Fsi-~.+e 6. Name of owner of the subsurface richts of affected land: E!'~'1 ~ ~ f SKO ~ T V US '~ 7. Name of owner of the surface of affected land: S 4 yN ~ 8. Tune of mining operation: _~ Surface Underground in-situ 9. Location information. The center of the area where the majority of mining will occur: COUNTY: 5~1.-. , . i ~ C K PRINCIPAL MERIDIAN (check one): /6th (COlorado)~_ 10th (New Mexico) Ute SECTION (write number): S J /er S-(I TOWNSHIP (write number and check direction): T 9 - N / North South RANGE (write number and check direction): R 2~ East / West QUARTER SECTION (check one): QUARTER/QUARTER SECTION (check one): _ NE NW ~SE SW NE NW SE ~ SW GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the approximate elevation) : 02 7 N1 i I P S S la) ~~ ~ 1 1 I e5 IO U/ 4 C O. 10. Primary future (Post-mininol land use (check one): Cropland(CR) Pastureland(PL) General Agriculture(GA) ~/ Rangeland(RL) Forestry(FR) Wildlife Habitat(WL) _ Residential(RS) Recreation(RC) Industrial/COm<oercial(IC) Developed Water Resourcea(WR) Solid Waste DispOSal(WD) 11. Pri.marv present land use (check one): _ Cropland(CR) Pastureland(PL) General Agriculture(GA) y/'Rangeland(RL) Forestry(FR) Wildlife Habitat(WL) Residential(RS) Recreation(RC) Industrial/Commercial(IC) Developed Water Resources (WR) Mining (HIi) 12. If this operation will use designated chemicals, or will result, or presently has acid mine drainage - you cannot use this application form. You must submit either a 110d or 112d application form for Designated Mining Operations. in either case, you moat list any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and whether the operation will result in or presently has acid mine drainage: 13. Description of Amendment or Conversion: If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s):