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`1 <br />1 I <br /> <br />II <br />I I <br />IIII <br />II <br />II III <br />I II I(}(ry~~yy //~fj/~'p ~fQ <br />I tlO~~V ~~~1[1 <br /> <br /> SF_p 819~g <br /> LIMITED IMPACT OPERATION (110(2)) MINED LAND <br />'' APPLICATION FORM RECLAMATION LI`J151O9d <br /> The Application fora Limited Impact Operation Reclamation Permit contains three major <br /> par ts: (1) the Application Farm. (2) the Application Exhibits A-F, and (3) the <br />' app l-ication fee. When you submit your Application, be sure to include two s-~i~ggn-~ed copies <br /> of the Application Form, two copies of Exhibits A-F, and a check for the app~on fee <br /> described under (4) below. To expedite processing, please provide the information in <br /> the format and order described in this form. <br /> GENERAL OPERATION INFORMATION <br />' or <br />print <br />clearly <br />in <br />Type <br />space provided_ <br />ail <br />information described below. <br />the <br /> --- - <br />- <br />- <br />- <br />-- <br />- <br />_ <br />- <br />- <br /> 1. Applicant/Operator Name: Deer Trail Sand & Gravel <br /> 2. Operation Name (Pit, mine Or site name): Deer Trail Sand & Gravel <br />' 3. Application type: Limited Impact Operation (110). <br /> 4. Application Fee for Permitted Acreage* 9.946 permitted acres. <br /> (S10 x (affected acres) + ~25.00).* <br />' Note permitted acreage and application fee and <br /> attach a check for this amount when you file. $125.00 application fee.- <br /> 5. Substance(s) to be mined (e.g., gold/silver/gravel): sand & gravel <br /> 6. Owners (s) of Substance to be Mined <br /> (check applicable box (s )): X Private _ State _ Federal _ Indian <br /> 7. Owner(s) of Record of Affected Land <br />' (check applicable box (s )): X Private _ State _ Federal _ Indian <br /> 8. Type of Mining Operation <br /> (check applicable box(s)): X Surface <br />Underground <br />In-situ <br /> _ <br />_ <br /> 9. Location Information. The center of the area where the majority of mining will <br /> occur lies in: <br />t COUNTY: Ara shoe <br />~ <br /> 6th (Colorado) 10th (New Mexico) Ute <br />PRINCIPLE R c ec. one <br /> North X South <br />TOWNSHIP (write number and check direction): T 5 <br /> _ <br />RANGE (write number and check direction): R 60 East g West <br /> - <br />SECTION (write number): S 24 <br /> QUARTER SECTION (check one): ~- NW SE X SW <br /> QUARTER/QUARTER SECTION (check one): _ NE ~ NW _ SE _ SW <br />' GENERAL DESCRIPTION: <br /> (miles and direction Approximately one mile southwest of Deer Trail, <br />' from nearest town and <br />approximate elevation) Colorado. ElevationColorado. Elevation 5300~eet. <br /> * If the operator is a unit of State or county government, an application fee is not <br /> req uired. A fraction of an acre must be counted as one acre for fee calculation. <br />1 <br />