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<br />9 ~~I <br /><.~~-T~~~,~~jQ, <br />nu c a o iss$ <br />LIMITED IMPACT OPERATION (110) <br />APPLICATION FORM <br />~~;~: ~.:r~ J.~c~L~ <br />This form contains two major parts: (1) General Operation Information and (2) Exhibits <br />A-G. When you submit your application, be sure to include two signed copies of the <br />General Operation Information, two copies of Exhibits A-G, and a~ck for the <br />application fee described under (4) below. To expedite processing, please provide the <br />information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />----------------------------------------------------------------------------------------- <br />----------------------------------------------------------------------------------------- <br />1. Applicant/Operator Name: southway construction co., Tnc. <br />2. Operation Name (Pit, mine or site name): swede corners Pit <br />3. Application type: Limited Impact Operation (110): <br />4. Application Fee (E10 x (affected acres) + 525.00).* 9,9 affected acres. <br /> Note affected acreage and application fee and <br /> attach a check for this amount when you file. izs.oo application fee, <br />5. Substance(s) to be mined (e.g., gold/silver/gravel): sana s travel <br />6. Owners(s) of Substance to be Mined <br /> (check applicable box(s)): O Private ^ State ® Federal ^ Indian <br />7. Owner(s) of Record of Affected Land <br /> (check applicable box(s)): ^ Private ^ State ® Federal ^ Indian <br />8. Type of Mining Operation <br /> (check applicable box(s)): ~ Surface ^ Underground ^ In-situ <br />9. Location Information. The center of the area where the majority of mining will <br /> occur lies in: <br />COUNTY: Saguache <br />PRINCIPLE R N c ec one 6th (Colorado) (New Mexico) Ute <br />TOWNSHIP (write number and check direction): T 4s ® North ^ South <br />RANGE (write number and check direction): R ~ [y] East ^ West <br />SECTION (write number): S z <br />QUARTER SECTION (check one): ^ ~ ^ NW ^ SE ® SW <br />QUARTER/QUARTER SECTION (check ane): ^ NE ® NW ^ SE ^ SW <br />GENERAL DESCRIPTION: <br />(miles and direction 6 miles South and 2 1/2 miles West of Saguac he <br />from nearest town and <br />approximate elevation) , <br />* If the operator is a unit of State or county government, an application fee is not <br />required. A fraction of an acre must be counted as one acre for fee calculation. <br />