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II IIIIIIIIIIIII III LIMITED IMPACT OPERATION (110(2)) RECLAMATION PERMIT AUr, 1. g ~gg~ APPLICATION FORM 11"i~nad ~dnd Reclamation. Division The application fora Limited Impact Operation Reclamation Permit contains three mayor parts: (1) the application form; (2) Exhibits A-J; and, (3) the application fee. When you submit your application, be sure to inciude two (2) signed originals of the application form, two (2) copies of Exhibits A-J, and a c"i`iecTc for the application fee described under (3) below. To expedite processing, please provide the information in the format and order described in this form. ~,~I_ /~ y ~( ~- ~)~ ~~~ -..3-.~~~..3~.~J3--3--2233a333323332333'133a393a3333a 3 a3ad 33323-3i~+.~3:6 3 3 3 2 GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, all information described below. 333332.23~~=332332332333~23323333a3333a333a333333a33a3333333233a32a3333333233233323~3333~ 7. Applicant/operator name: Gunnison Countv Road & Bridee )Zegartment 1.1 Type of organization (Corporation, partnership, etc.): Countv Government 2. Operation name (pit, mine or site name): Nicolas Brothers Pit Z.1 I.R.S. Tax ID No, or Social Security No.: 3. Application fee for permitted acreage* 3 5 permitted acres Nate permitted acreage and application fee and attach a check for this amount when you file. N/A application fee 4. Substance(s) to be mined (e,q., gravel/gold/borrow): August & Paul Nicolas 5. Name of owner of surface of affected land: dba Nicol as Brothers August & Paul Nicolas 6, Name of owner of subsurface rights of affected land: dba Nicolas Brothers 7, Type of mining operation: x Surface _ Underground _ In-situ 8. Location information. The center of the area where the majority of mining will occur lies in: COUNTY: Gunnison PRINCIPAL MERIDIAN (check one): 6th (Colorado) X 10th (New Mexico) Ute TOWNSHIP (write number and check direction): T [ ~ North -south RANGE (write number and check direction): R _~ _ East g West SECTION (write number): S ~ QUARTER SECTION (check one): ~ NW SE SW QUARTER/QUARTER SECTION (check one): _ NE _ NW _ SE SW GENERAL DESCRIPTION: (miles and direction Elevation - - 7.500 feet from nearest town and approximate elevation] Gunnison 45 miles east Montrose 25 miles crest NRECEiV~p * A fraction of an acre mist 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,