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~ . ~ r RECEIVEC~ <br />' LIMITS-III IIIIIIIIIIIIIIII (110(2)) NOV 181992 <br />RECLAMATION PERMIT DIVISIOrv Uh <br />APPLICATION FORM MINERALS & GEOL _i(+'' <br />CHECK-ONE: ~- New Application CRute 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 />a, 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 processin please provide the in'ormation <br />in the format and order described in this form. <br />________________________________________~__~__=_________~_~~===1~~ _= a~13~ <br />GENERAL OPERATION .INFORMATION <br />Type or pr'ir.t clna, iy, 'in tne.s.pace.ar~ovi,ded„al l_.in:fgrm3tien desCribe~,,pelow. <br />a~ ..i ,..: ~-.~:.., ~T ~ ~Y J,~y, •,•~-~--•r ~.~x~a+'~' t+',tP'-5K~ 1 .:=`'. ~7,rr'+w ~.:+5-s:r -`. <br />.,,i~ .. , , ~ ..t", _ e ..XnPAT3L.0~V;AS~1~1 F~'s2 ~;. Jk +~. $+d`~. ~ <br />( 9 V .. 1: <br />t <br />- - : ~ -t ~~~ f~y1~}~r~~~'Fn d'1; q ,~[ .~{p~2 Cry`' ~°AkTNFR iliF~~ :` qa 4 :. <br />_.. Opzrr _,. .ar_ ._ -. a'~nz'pr='i.>:er.namev•:•. - tt•A~n'~i7[)y~cTnmF' , <br />2.i I.R.;i. lax IO No or Social Szcurity No.: 523--~-6 <br />1~.5 <br />:,. ?zr^~~: ttzd acreae pers.i :*_ed acres <br />3.'. ica:-icn ~e2 (New Application Only) 5815.00 appi`ca.tion fez <br />"<4.' ,Su5~kar:czds% :a be,:n'.cied,(e:g„ gravel/tgold/bo.rrow); REDSTONE ~ - <br />r 5: Name ~.if oNne,r,.o, ~u-race-of .affected landr~<`.'FABi~N` .. <br />a ~,.: -:. .... - ,4,c -.... - - <br />a.' NamE°:,f cwne'r~`of subsurface`rights of affected land: FABIAN <br />i. Type of mining operation:-"`.x Surface _ Underground _ In-situ <br />8. Loco[i,on.i;n`ormation,_~`,,T,he__.center of the area where the majority of mining will <br />occur lies i'nr ` <br />' COUNTY: 30ULDER <br />PRINCIPAL MERIDIAN (check one): <br />6th (Colorado) 10th (New Mexico) _ Ute <br />_ <br />TOWNSHIP (write number and check direction) : T 3 x North _ South <br />RAIJGE (write number and check direction): R 71 _ East x West <br />SECT.ION_ (write number)a.,-.;. :- S ~_ <br />QUARJ~ER:SECTION Ccheck~one)r-? x NE NW 5E SW <br />r ° QUARTER./QUARTER°°SE <br />;C_TION .(e~heck one>: x NE NW _ SE <br />: _ SW <br />~ <br />GENERAL DESCRIPTLON':~d'_-'"''•:` ~'"' = . <br />_ <br />- <br />(miles and direction _ 8 MILE NORTH WEST OF LYONS OFF HIGHWAY <br />from nearest town and <br />approximate elevation) 56 (ItFF('H TTT 1 <br /> <br />;~ <br />