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~ ~ ~ REC~IVEU <br />III IIIIIIIIIIIIIIII <br />LIMITED IMPACT OPtKHIlUfV ~i10(2)) ~~~ 2 8 1994 <br />RECLAMATION PERMIT <br />S/ c ghfi APPLICATION FORM O`'~~•~~ e'~~nneih~,,,ueoieoy <br />bl M <br />CHECK ONE: _~ New Ap~ ication (Rule 3.2> Amendment Application (Rule 1.8) <br />Conversion Application (Rule 1.10) <br />The application for a Limited Impact Operation Reclamation Permit contains three major <br />parts: (1) the application form; (2) Exhibits A-J; and, (3> the application fee. When <br />you submit your application, be sure to include one (1) si ned original and one (1) copy <br />of the application form, two (2) copies of Exhibits A-J, and a check for the application <br />fee described under (3) below. To expedite processing, please provide the information <br />in the format and order described in this form. ~~- ~~~~-C-7' <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/operator name: <br />WASHINGTON COUNTY <br />1.1 Type of organization (corporation, partnership, etc.): „_,;.,__, ,.__ _ _,_~ <br />2. Operation name (pit, mine or site dame): N;rkp„ r.,-a..a, v;t F;,o rte M-9h-OZz <br />2.1 I.R.S. Tax ID No. or Social Security No.: a4_~nnn,a, <br />3. Permitted acreage a_s, permitted acres <br />3.1 Application Fee (New Application Only) 5875.00 application fee <br />4. Substance(s) to be mined (e.g., gravel/gold/borrow): rra„A, <br />5. Name of owner of surface of affected land: TarF,a Nirkal, (l;fn Acr~ro~ <br />6. Name of owner of subsurface rights of affected land: r.a rha N;rko „ <br />7. Type of mining operation: ~ Surface _ Underground _ In-situ <br />8. Location information. The center of the area where the majority of mining will <br />occur lies in: <br />COUNTY: Washingrnn <br />PRINCIPAL MERIDIAN (check one): ~ 6th (Colorado) 10th (New Mexico) _ Ute <br />TOWNSHIP (write number and check direction): T 5 _ North x South <br />RANGE (write number and check direction): R 55 East X West <br />SECTION (write number): S 30 _ <br />QUARTER SECTION (check one): NE NW x SE SW <br />QUARTER/QUARTER SECTION (check one): NE x NW _ SE _ SW <br />_ <br />GENERAL DESCRIPTION: <br />(miles and direction 11 miles South and 'z mile east of Last Chance, CO. <br />from nearest town and <br />dpprOxlmdte eleVdtlOn) 5218 feet elevation <br />` ' ORIGINAL <br />