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" ~ III IIIIIIIIIIIIIIII 'I,$ • sss FEB ?3 198T o~' a`5 LIMITED IMPACT OPERATION (110) MINED LAND APPLICATION FORM IiECLAMATION DIVISION This form contains two mayor parts: (1) General Operation Information and (2) Exhibits A-G. When you submit your application, be sure to Include two s~ign~ed copies of the General Operation Information, two copies of Exhibits A-G, and a C e k for the application fee described under (4) below. To expedite processing, please provide the information in the format and order described in this form. rYi_~)_p,/~ ~I~Sop ~~I,IS asaaaaasaaaasaaaaaaeaaasaaaaaaaeaa:aaaaaaaaaaaaaaaaaaaaasaa aaaaa__aaa__a_____--aa-- aaea GENERAL OPERATION INFORMATION Type or print clearly. in the space provided, all information described below. ~aaaaaaaaaseaaaaaaaaaaaaaaoaaaasaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaeeaaaaaaaaaaaaaaaaaaa 1. Applicant/Operator Name: Colorado puarries. Inc. 2. Operation Name (Pit, mine or siteiname): Lily Mines 3. Application type: Limited Impact Operation (110). 4. Application Fee for Permitted Acreage* 9 permitted acres. (S10 x (affected acres) + =25.00).* Note permitted acreage and application fee and attach a check for this amount when you file. siis.oo application fee. 5. Substance(s) to be ml ned (e. g., gold/silver/gravel): write Marble 6. 1. 8. 9. Owners(s) of Substance to be Mined (check applicable box(s)): Owner(s) of Record of Affected Land (check applicable box(s)): Type of Mining Operation (check applicable box(s)): ® Private ^ State ^ Federal ^ Indian ® Private ^ State ^ Federal O Indian ® Surface ^ Underground ^ In-situ Location Information. The center~of the area where the maJority of mining will occur lies in: COUNTY: Chaffee PRINCIPLE M R D c ec one ~ ^ 6th (Colorado) ^ 10th (New Mexico)^ Ute TOWNSHIP (write number and check direction): T so ® North ^ South RANGE (write number and check direction): R 6 ® East ^ West SECTION (write number): S 22 QUARTER SECTION (check one): ^'~- ^ QUARTER/QUARTER SECTION (check one): ® NE ^ GENERAL DESCRIPTION: (miles and direction 1.5•Miles North Garfield from nearest town and NW ® SE ^ SW NW ^ SE ^ SW Colorado approximate elevation) Elevation ii,zso * If the operator is a unit of State or county government, an application fee is not required. A fraction of an acre must be counted as one acre for fee calculation.