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(Not for DP Entry) <br />Permitted <br />Actual <br />Proposed <br />8. Mineral ownership: <br />Indicate currently permitted acreage for each <br />Federal: acres <br />0 <br />0 <br />0 <br />State: acres <br />0 <br />0 <br />0 <br />Private: acres <br />3,142 <br />3,142 <br />0 <br />Indian: acres <br />0 <br />0 <br />0 <br />9. Surface ownership: <br />Indicate currently permitted acreage for each <br />Federal: acres <br />0 <br />0 <br />0 <br />State: acres <br />0 <br />0 <br />0 <br />Private: acres <br />3,142 <br />3,142 <br />0 <br />Indian: acres <br />0 <br />0 <br />0 <br />10. Affected area (in acres) <br />655 <br />155.6 <br />0 <br />11. Disturbed area (in acres) <br />655 <br />155.6 <br />0 <br />12. Acreage of area reclaimed in previous permit term <br />A. Backfilled and graded <br />N/A <br />122.5 <br />N/A <br />B. Retopsoiled <br />N/A <br />123.9 <br />N/A <br />C. Reseeded <br />N/A <br />123.9 <br />N/A <br />13. Acreage for which bond has been released <br />A. 60 percent <br />N/A <br />122.1 <br />N/A <br />B. 85 percent <br />N/A <br />0 . 0 <br />N/A <br />C. 100 percent <br />N/A <br />27.2 <br />N/A <br />14. Renewal Term Requested (Years) <br />N/A <br />N/A <br />5 <br />Note: If the application contains proposed (new) acreage, then a permit revision application <br />form must also be completed for those acreages. <br />3 <br />General Description (Miles and direction from nearest town and approximate elevation): <br />Three miles west of Segundo, Colorado, on Highway 12. Approximately 20 miles west of <br />Trinidad, Colorado on Highway 12. <br />15. Type of Mine (Check one): _ Underground ✓ Surface <br />_ Combined Surface and Underground <br />Loadout Other <br />