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<br />.. III1111111111111111 °rr='''FD <br />LIMITS. _. 999 (110(2)) AUG 29 1994 <br />RECLAMATION PERMIT <br />APPLICATION FORM <br />CHECK ONE: x New A lication (Rule 3.2> Amendment A""li'ca`ti`on Ru ey1.8) <br />PP PP ~~ <br />Conversion Application (Rule 1.10) <br />The application for a Limited Impact Operation Reclamation Permit contains three mayor <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) signed 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 to this form. ~ zL „ ~ ~ Z <br />vvvvvvvvvsrvvvvrvvvvrvvvvrvvvvrvvvvrvvvvvvvavvvvvvvvvvvvvvvvvvvvvvvvav vvvrvvvvavvvvvvavv <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />rvvvvrvvvvrvvvvrvvvarvvvvrvvvvvvvvvvvvvvvvvvvvvvvvvevavvvvvvvvvvvvvvvvvvvvvcvvvvvvavvvvvv <br />Applicant/operator ndme' Fremont County Board of County Commissioners <br />1.1 Type of organization (corporation, partnership, etc.): <br />Governmental Entity <br />2. Operation ndme (p1 t, mine Or Site 11ame):Fremont County's Iron Mountain Road Gravel Pit <br />2.1 I.R.S. Tax ID No. or Social Security No.: <br />3. Permitted acreage <br />3.1 Application Fee (New Application Only) <br /> <br />4. Substance(s) to be mined <e.g., gravel/gold/borrox): <br />9.8 permitted acres <br />$875.00 application fee <br />Gravel <br />5. Name of Owner of surface Of affected land: Bureau of Land Management <br />6. Name of owner of subsurface rights of affected land: Bureau of Land Management <br />7. Type of mining operation: x 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: Fremont <br />PRINCIPAL MERIDIAN (check one): x 6th (Colorado) 10th (New Mexico) Ute <br />TOWNSHIP (write number and check direction): T i9 _ North x South <br />RANGE (write number and check direction): R 72 _ East x West <br />SECTION (write number): S 32 <br />QUARTER SECTION (check one): _ NE x NW SE _ SW <br />QUARTER/QUARTER SECTION (check one): NE _ NW x SE SW <br />GENERAL DESCRIPTION: <br />(miles and direction Avoroximately 28 miles Southwest of Canon City <br />from nearest town and <br />approximate elevation) 1.500 feec <br />CO°Y <br />