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REGULAR OPERATION (112)
<br />RECLAMATION PERMIT
<br />APPLICATION FORM
<br />CHECK ONE: ,~ New Application (Rule 2) _
<br />_ Conversion Application (Rule 1.10)
<br />1
<br />Amendment Application (Rule 1.8)
<br />The application far a Regular Operation Reclamation Permit contains three major parts:
<br />(1) the application form; C2) Exhibits A-S; and, C3) the application fee. When you
<br />suhmit your application, be sure to include one Cl) signed original and four (4) signed
<br />copies of the application form, five (5) copies of Exhibits A-S, and a check for the
<br />application fee described under Section (14) on Page 3. To expedite processing, please
<br />provide the information in the format and order described in this form.
<br />GENERAL OPERATION INFORMATION
<br />Type or print clearly, in the space provided, ail information described below.
<br />1. Applicant/operator name: ~\•,\\; /- ..~,:.,,\~-..~\ ~..~~s~...~.~-.r,1~~s L
<br />1.1 Type of organization (corporation, partnership, etc.): L~..~.+-~ ~~.,~--.c,~n~,~
<br />r
<br />2. Operation name (pit, mine or site name): 5,,,.-,,,", ~„~~ ~-,,.,,,,..e_` p.-
<br />2.1 I.R.S. Tax ID No. or Social Security No.: g~{ - 1 !:~ O $J~
<br />3. Permitted Acres: -t-1~ n Permitted acres
<br /> Please indicate acreage to the nearest tenth ( 10th) acre.
<br /> 3.1 Application fee (see Section 14): A
<br />pplication fee
<br />4. Substance(s) to be mined (e.g., gravel/gold/borrow): p
<br />o~~n,_,.,-e...\
<br /> V
<br />
<br />5.
<br />Name of owner of surface of affected land: ,
<br />M:\\. .,, /~..~:.~...~~~.. L~
<br /> ,~
<br />.6. Name of owner of subsurface rights of affected land: s---.~ ~ t a-~ ~.-~
<br /> If 2 or more owners; refer to Exhibit P.
<br />7. Type of mining operation: ~c Surface _ Unaerground
<br />9. Location Information: the center of the area where the majority of mining will
<br /> occur lies in:
<br /> COUNTY: M ~-r. \~--v-os 2
<br /> PRINCIPAL MERIDIAN (check one): x 6th (Colorado) 10th (New Mexico) J Ute
<br /> TOWNSHIP (write number and check direction): T ~ `i x North South
<br /> RANGE (writs number and check direction): R East K West
<br />~
<br /> SECTION (write number): S -
<br />i ~
<br /> QUARTER SECTION Ccheck one): NE ~ NW _ SE _ SW
<br /> QUARTER/QUARTER SECTION (check one): _
<br />_ NE _ NW ~ SE _ SW
<br /> Gc"NERAL DESCRIr'TION:
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<br /> (m i 1 e s and d i r e c t i on
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<br /> from nearest town and - '"
<br />approximate elevation) ~~
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<br />;~ S 7 9C ~-.a~
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