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_z_ <br />3. Address and shone ,Vumoer or <br />zz2 South 6th street <br /> Local Or r ices Grand Junction, CO 81501 <br /> 248-7208 <br />4'. Ad cress and ?none ilum oer of 4201 E. Arkansas Ave. <br /> i~neral Of `ices Denver, CO 80222 <br /> (303) 757-9224 <br />~. Name and ?hone ilu~noer or Person Local - Robert Lucas - 248-7229 <br /> Start iie: noers Should i;ontact General - Dick Hines - 7s7-9224 <br />d. Owner(s) or Record of Afrected Land Bureau of Land Management <br /> (surface area) (If m ore than 2, list below) <br />7. Owner(s) of Substance to be iNined Bureau of Land Management <br /> (If more than 2, list below) <br />d. Source of Legal Right-To-Enter g~ Free Use Permit <br />(indicate what type of proof is permit No. C-0128461 <br />included in EXHIBIT G - lease, <br />deed, notarized letter, etc.) <br />9. Type of Fiine and Substance to be Mined <br />(Specify underground, open pit, Open pit mine <br />quarry, etc. ~ substance{s) to Burnt shale to be mined <br />oe mined) <br />lU. General Location and Elevation 20.3 miles N. of Ipma Colorado on <br />(Miles & direction from nearest 1Lighway 139- <br />to~an & approximate site elevation) Elev. 5600 ft. <br />11. County Garfield <br />12. Acreage of Affected Lands <br />(Tctal surface acreage to be 3.27 acres <br />included in permit] <br />13. Application Fee (See applicable <br />Rule to deternine amount) N/A <br />