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UN. c.D STATES <br />DEPARTMENT OF THE INTERIOR <br />BUREAU OF LAND MANAGEMENT <br />SPECIAL LAND-USE APPLICATION AND PERMIT <br />APPLICATION <br />FORM APPROVED <br />OMB NO. 42-n^^0996 <br />Serial Number <br />C-18213 <br />INSTRUCTIONS ON REVERSE <br />1. Name (first, middle initial, and last) Address (include zip code) <br />UNION CARBIDE CORPORATION P 0o 1049 <br />Mining and Metals Division Gran unction, Colorado 81501 <br />2. Give legal description of public lands for which you are applying <br />TOWNSHIP RANGE SECTION SUBDIVISION <br />44N 18W 30 NE'?EkNEkSEk;, XW'kNW-VIEkSEk, W' NE'kNWkNEkSE -, <br />29 NW`JVA4NEkSW'k <br />; 94,0crCh <br />Meridian State County Acres nu <br />NMPM Colorado San Miguel 8.75 <br />3. For how many years are you requesting this permit? 10 <br />4a. Are you 21 years of age or over? b Are you a citizen of the United States or have you declared <br />[] Yes [] No your intention? ? Yes [] No <br />As applicant, are you a ? Partnership ? Association ? Corporation; <br />C. or an agency of ? Federal Government ? State Government ? Political subdivision of any state? <br />d. Are the statements required by Instruction Number 2 attached? U Yes ? No ? Not applicable <br />5. Are you making this application for your own use and benefit? [x] Yes ? No (l/ "no," explain) <br />6. Are the lands now improved, occupied, or used? ? Yes L] No (1l "yes," describe improvements and pur- <br />poses, identity users and occupants) Lands are used as a site for depositing waste rock from. <br />mining operations. <br />7a. What do you propose to use the lands for? Principally as storage area for mine waste rock which <br />may at some future time be sorted to recover additional mineral values - access to <br />mine adits are also across a small portion of the land requested. <br />b. What improvements, including sanitation facilities, do you intend to make? (Describe improvements and attach <br />drawings, i/ convenient) :When mining operations are completed the piles will be contoured <br />to avoid erosion and restoration of natural vegetation will be assisted by seeding <br />where feasible. No sanitation facilities involved. <br />*The cost of the reclamation work is impossible to estimate at this time because the <br />magnitude - of the job will not be known until it is undertaken. <br />What is the estimated <br />c. cost of proposed improve- <br />ment? $ *see above <br />d. What is the proposed source of water for domestic or other uses? <br />None required. <br />8. Have you enclosed filing fee of S10? [x] Yes [] No (Sec Instruction Number 3) <br />I CERTIFY That the information given by me in this application is true com ete, and ccrrect to the best of my <br />knowledge and belief and is given in gout; faith.NION E RlPORATION <br />Vic President of its <br />May 11, 1973 Mining and Metals Division <br />(Date) (Signature of Applicant) <br />Title 18 U.S.C. Sec tton 1001, makes it a crime for anv person knowingly "rid willful • o make to any department or agency of the <br />United States any false fictitious, or fraudulent statt•mentc, or repres lntior}c Pe to any mmatttoe-rr within its jurisdiction.