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REGULAR OPERATION (112) <br />RECLAMATION PERidIT <br />APPLICATION FORM <br />The application for a Regular Operation Reclamation Permit contains three major parts: <br />(i) tire application form; (2) Exhibits A-S; and, (3) the application fee. When you <br />submit your a~iplicatlon, be sure to include five (5) sl ned copies of the application <br />form five (5) copies of Exhibits A-S, and a check for the application fee described <br />under Section (14) on Page 3. 7o expedite processing, please provide the information In <br />tlce Format and order described In tills form. <br />GENERAL OPERATION INFORMATION <br />type or print clearly, fn the space provided, all Information described below. <br />I. Applicant/operator name: SAND CREEK FARMS INC. _ <br />1.1 Type of organization (corporation, partnersiclp, etc.>: Corporation _ <br />2. Operation name (pit, mine or site name): SAND CREEK MINE _ <br />2.I I.R.S. Tax ID No. or Social Security No.: 7~ax ID _ <br />3. Permitted Acres: 40 Permitted acres <br />Please indicate acreage to the nearest tenth (10th) acre. <br />• 3.1 Alrplicatton fee (see Section 14): $2,325.00 Apl~licatfon Fee <br />4. Substance(s) to be mined (e.g., gravel/gold/borrow): Sand/Grav<:1 <br />5. Name of owner of surface of affected land: Sand Creek Farms. Inc. <br />G. Name of owner of subsurface rights of affected land: Sand Creek Farms, Inc. <br />if 2 or more owners, refer to Exliiblt P. <br />7. Type of mining operation: x SurFace _ Underground <br />8. Location Inforinatton: the center of the area where the majority of mining will <br />occur Iles In: <br />COUNTY: ADAMS <br />PRIN(:[PAL MERIDIAN (check one): X 6th (Colorado) 10th (New Mexico) Ute <br />TOWNSHIP (write number and check direction): T _ <br />3 North X <br />^ 'South <br />RANGE (write number and check direction): R 61 _ East X West <br />SECTION (write number): S 3 - Soul-h IIa.Lf <br />QUARTER SECTION (check one): NE NW _ SE SW <br />QUARTER/QUARTER SECTION (check one): _ NE NW _ SE ` SW <br />GENERAL DESCRIPTION: _ _ <br />(miles and direction Auproximately 7 1 /2 miles north~,f_ BV rc._ <br />From nearest town and <br />Colorado. <br />approximate elevation) Approximate elevation = 5,400. <br />• <br /> <br />