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REGULAR OPERATION (112) <br />RECLAMATION PERMIT <br />APPLICATION FORM <br />0 tri <br />! cn A l in <br />CHECK ONE: New Application (Rule 1.4.5) Amendment DWIe 1.10) <br />Conversion Application (Rule 1.11) <br />APR 2 6 1999 <br />Permit No. M- (provide for amendments and conversions of existing <br />permits) Division of Minerals & Geology <br />The application for a Regular Operation Reclamation Permit contains three major parts: (1) <br />the application form; (2) Exhibits A -S and Geotechnical Stability Exhibit; and, (3) the . <br />application fee. When you submit your application, be sure to include one (1) signed and <br />notarized original and four (4) copies of the application form, five (5) copies of Exhibits <br />A -R and any required sections of Exhibit S and the Geotechnical Stability Exhibit, and a <br />check for the application fee described under Section (16) on Page 3. Exhibits should not <br />be bound or in a 3 -ring binder; maps should be folded to 8 1/2" X 11" or 8 1/2" X 14" size. <br />To expedite processing, please provide the information in the format and order described <br />in this form. <br />-9q- 05 L <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant /operator or company name (name to be used on permit): <br />AmPrAlia, Tnr <br />1.1 Type of organization ( <br /> <br /> <br />Nahcolite Mine Project <br />3. Permitted acreage (new or existing site) 1.319.59 permitted acres <br />3.1 Change in acreage (+ or -) • acres <br />3.2 Total acreage in Permit area 1,319 59 acres <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.3 Milling Application (Non -DMO) <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set <br />PRINCIPAL MERIDIAN (check one) : )(,,_ 6th (Colorado) .r.r 10th <br />SECTION (write number): S <br />TOWNSHIP (write number and check direction): T <br />RANGE (write number and check direction): R qR <br />QUARTER SECTION (check one): _ NE _ <br />QUARTER /QUARTER SECTION (check one): NE <br />GENERAL DESCRIPTION (miles and direction from nearest <br />elevation): The site is approximately 22 miles southeast <br />6500 ft elevation. <br />$1,875.00 application fee <br />$2.325.00 quarry application <br />$3,100.00 milling application <br />$1,550.00 amendment fee <br />by statute) $1,500.00 conversion fee <br />5. Primary commoditie(s) to be mined: nahcolite <br />6. Name of owner of surface of affected land: Bureau of land Management <br />7. Name of owner of subsurface rights of affected land: Riireaii of land Management <br />If 2 or more owners, refer to Exhibit O. <br />8. Type of mining operation: _ Surface _ Underground X In -situ <br />9. Location Information: the center of the area where the majority of, mining will <br />occur lies in: <br />COUNTY: Rio Blanco <br />(New Mexico) _ Ute <br />_ N o r X South <br />E a st West <br />NW _ SE SW <br />NW SE SW <br />town and _ approximate <br />of Rangely at about <br />