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\ . ~~M III a^^^{11 <br />I .. • ^ \l 1 ~IIIIIIIIII~~ ^ 11 ~ ~ • _ ^}^7 ~ j .-~ . ~ .. J . <br />~~ U 61 t w ~ Y ~~ ~ ~r.~ ~ Fl~) <br />JUl a 7 +;)y~ <br />Rhl1~l~V LArdLJ <br />LIMITED IMPACT OPERATION (110) <br />APPLICATION FORM <br />This form contains two major parts: (1) General Operation Information and (2) Exhibits <br />A-G. When you submit your application, be sure to include two ~~siyyn~~ed copies of the <br />General Operation Information, two copies of Exhibits A-G, and as e k for the <br />application fee described under (4) below. To expedite processing, please provide the <br />information in the format and order described in this form. m _~~ J Oho <br />c_.vccevcc_ev:cccccccvv=ecaccvescecee.cccevccvcc-.evcvv.vxeco_cc__c_cceccccceveccec.v.ccc <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/Operator Name: RBK Construction, Inc. <br />2. Operation Name (Ptt, mine or site name): RBK Pit No. 30 <br />3. Application type: Limited Impact Operation (110). <br />4. Application Fee for Permitted Acreage* 9.9 permitted acres. <br /> (E10 x (affected acres) + E25.00).* <br /> Note permitted acreage and application fee and <br /> attach a check for this amount when you file. $124.00 application fee. <br />5. Substance(s) to be mined (e. g., sold/silver/gravel): Gravel <br />6. Owners(s) of Substance to be Mined <br /> (check applicable box(s)): S~' Private ^ State ^ Federal ^ Indian <br />7. Owner(s) of Record of Affected Land <br /> (check applicable box(s}): ~'i Private ^ State ^ Federal ^ Indian <br />8. Type of Mining Operation <br /> (check applicable box(s)): 1~ Surface ^ Underground ^ In-situ <br />9. Location Information. The center of the area where the majority of mining will <br /> occur lies in: <br />COUNTY: Pueblo <br />PRINCIPLE M R D AN c ec one 1~ 6th (Colorado) ^ 10th (New Mexico)^ Ute <br />TOWNSHIP (write number and check direction): T ~ ^ North O South <br />RANGE (write nunber and check direction): _ <br />R ~~ ^ East ~ West <br />SECTION (write number): S <br />QUARTER SECTION (check one): ^~ ^ NW S SE ^ SW <br />QUARTER/QUARTER SECTION (check one): O NE ^ NW ~ SE ^ SW <br />GENERAL DESCRIPTION: <br />(miles and direction 10 Miles East of Pueblo <br />from nearest town and <br />approximate elevation) Elev. = 4570 <br /> <br />* If the operator is a unit of State or county government, an application fee is not <br />required. A fraction of an acre must be counted as one acre for fee calculation. <br />