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<br />REGULAR OPERATION (112) <br />RECLAMATION PfiRMIT <br />APPLICATION FORM <br />CHECK ONfi: New Application (Rule 1.4.5) _ <br />,~ Conversion Application (Rule 1.11) <br />~e~~~v~~.~ ~' <br />JAN 10 1996 <br />9iVielan of Mingr~l8 8 Qaolapy <br />Amendment Application (Rule 1.10) <br />C~~IV - DO/ <br />Permit No. M-~~- D/ (provide for amendments and conversions of existing <br />permits) <br />The application for a Regular Operation Reclamation Permit contains three major parts: (1) <br />the application form; (2) Exhibits A-S and Geoterhnical Stability Exhibit; and, (3) the <br />application fee. When you submit your application, be sure to include one (1) signed and <br />notarized original and four (4) copies of the application form, five (5) copies of Exhibits <br />A-R and any required sections of Exhibit Sand the Geoterhnical Stability Exhibit, and a <br />check for the application fee described under Section (16) on Page 3. Exhibits should not <br />be bound or is a 3-ring binder; maps should be folded to 8 1/2" X il" or 8 1/2^ X 14^ size. <br />To expedite processing, please provide the information in the fo and order described <br />in this form. -~ <br />_ 72 <br />-------------------------------------------=----------------- f <br />GfiNERAL OPERATION INFORMATION <br />Type or print clearly, in the apace provided, all information described below. <br />i. Applicant/operator or company name (name to be used on permit): <br />1.1 Type of organization (corporation, partnership, etc.) : Cp uni7V !S/I Yt~R/V/1 <br />1.2 I.R.S. Tax ID No. or Social Security Number: 8''/- GOOO - 792. <br />2. Operation. name (pit, mine or site name) : EAFVEa /~~,LE PiT <br />3. Permitted acreage (new or existing site) S,D permitted acres <br />3 . i Change in acreage (+ or -) + ~`f . 6 N acres <br />3.2 Total acreage in Permit azea .esq. /off acres <br />4. Fees: <br />4.1 New Application 51,875.00 application fee <br />4.2 New Quarry Application 52,325.00 quarry application <br />4.3 Milling Application (Non-DMO) 53.100.00 milling application <br />4.4 Amendment Fee ~ 51,550.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) 51.500.00 conversion fee <br />5. Primary commoditie (s) to be mined: $fl N0 '~ GRAVBL <br />6. Name of owner of surface of affected land: Pi4 R ~' <br />7. Name of owner of subsurface rights of affected land: ~a/Q K_ <br />If 2 or more owners, refer to Exhibit O. <br />8. Type of mining operation: X Surface Underground in-situ <br />9. Location Information: the center of the area where the majority of.miniag will <br />occur lies in: <br />. rnUNTr: P.a~t/C <br />PRINCIPAL MERIDIAN (check one): X 6th (Colorado) 10th (New Mexico) _ Dte <br />SECTION (write number): S <br />TOWNSHIP (write number and check direction): T _ North ~ South <br />RANGE (write number and check direction): R Eas ~ West <br />QUARTER SfiCTZON (check one): _ NE _ NW ~ SE _ SW <br />QUARTER/QUARTER SECTION (check one): NE NW ~ SE SW <br />GENfi RAL DESCRIPTION (miles anti direction from nearest town and approximate <br />elevation) : T,~~/T / ~fF~/~ ~1,1~ if Mf~L~S F I('bM NQRY'SEL L~ <br />F1~/FN M~Af /?» i ~ APFNOA' .49 ra rC'l F~.n~~A~rI~N <br />E~VT <br />ORIGINAL <br />