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Home My WebLink AboutC87-056 Free Use Application and Permit vegetative or mineral materiali . Form 5510-1 (May 1985) Name of applicant Address (include zip code) Eagle County Board of Commissioners P.O. Box 850, Eagle Colorado 81631 Kind of material Basalt Rock Estimated quantity 1,000 cuY ds Give legal land description TOWNSHIP RANGE SECTION SUBDIVISION Township 7 South, Range 87 West, Section 35: within SWI/4SW1/4 , State of Colorado County of BOOK...J... Eagle Materials are to be used for PAGE... I HEREBY AGREE TO COMPLY WITH the special conditions as set forth below. I CERTIFY That the: (a) materials to be removed are to be used for the purpose noted above; (b) none of the materials removed are to be sold or bartered; (c) removal of materials can begin only upon receipt of an approved copy of this permit; and, (d) the authorized oficer is to be notified upon completion of removal. JOHNNZ-f FL I CERTIFY That I am a citizen of the United States, and of the age of majority in the State in which I reside. �� I FURTHER CERTIFY That the statements made by me in this application are true, complete, and co the tiest of my knowledge and belief and are made in good faith. 3 4 31 all X A3 (Date) ig ure of ant) Title 18 U.S.C. Section 1001, makes it a crime for any person knowingly and willfully to make to any department or agency a U oft nite tates " y a , fictitious, or fraudulent statements or representations as to any matter within its jurisdiction. PERMIT SPECIAL CONDITIONS This permit is hereby issued for the.materials applied.for:but'maycbe canceled if it appears that this permit was issued erroneously or the terms or conditions contained herein are not observed. It shall be subject to the following special conditions: SEE EXHIBIT A, ATTACHED HERETO AND MADE A PART HEREOF: Information is collected to comply with Statutes (16 U.S.C. 604-606 and agency Regulations (43 CFR 5511.1-1(f)). Information is used to confirm the residence of the applicant. Applicant must respond to obtain a permit. Conservation practices must be carried out as provided by 43 CFR 5511.1-1(b), The permittee shall clean up all work areas and shall remove or dispose of all .2-3(c), and .3-3; refuse resulting from the permittee's operations; Equipment, personal property, and improvements must be removed within This permit is issued under the Act of July 31, 1947, as amended, and 43 U.S.C. ninety (90) days after expiration date 43 CFR 5511.3-5); and 1201, and under the free use privilege of the Act of May 14, 1898 (Alaska). Any use of the surface of the lands involved in this permit shall be such as not to An annual report indicating the amount (cu. yds. or tons) of material removed interfere with any mining claim subject to the provisions of Section 4 of the Act of must be filed with the District Office on the anniversary date of the permit, or July23, 1955 0 U.S.C. 613); within thirty (30) days after permit expiration. d Area Manger, Glenwood Springs (Date) (Signature of Authorized Officer) APPLICANT UNITED STATES DEPARTMENT OF THE INTERIOR BUREAU OF LAND MANAGEMENT FREE USE APPLICATION AND PERMIT VEGETATIVE OR MINERAL MATERIAL APPLICATION C87-56-38 FORM APPROVED OMB NO. 1004-0001 Expires: October 31, 1987 Permit Number 87-005 Expiration Date March 1, 1988 -111111LGrand Junction EXHIBIT A SPECIAL STIPULATIONS FREE USE PERMIT CO -077-07-005 EAGLE COUNTY BOARD OF COMMISSIONERS The Holder Shall: 1. Mulch and seed all disturbed areas following project completion to the satisfaction of the authorized officer. 2. Halt all work and activity at the site if cultural resources are discovered at the site and notify the authorized officer of such a discovery. - 3. If the holder allows a subcontractor to complete removal of the materials, the holder shall notify the authorized officer of the contractors name and representative. If the materials are removed by a subcontractor, the holder will maintain all responsibilities for compliance with the terms and conditions of this permit. 4. The holder or holders' subcontractors shall work cooperatively with the Colorado Division of Wildlife to coordinate the removal and rehabilitation at the site as both entities are permitted to be operating at the site during the same time periods. 5. The holder or holders' subcontractors shall obtain all necessary permission to gain access on private lands to enter and exit the site. Furthermore, they shall indemnify and hold harmless, the United States for any use and associated liability of the private lands used to access the permitted site. 6. The holder shall notify the authorized officer when mining and rehabilitation has been completed at the site.