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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 RECEIVED COLORADO <br />Denver, Colorado 80203 <br />utvIsioN or <br />Phone: (303) 866 -3567 RECLAMATION <br />FAX: (303) 832 -8106 SEf p 10 2013 MIN 1 N G <br />Divi W of Recl�lmetlon, SAFETY <br />Mining & Sty" <br />CONSTRUCTION MATERIALS <br />LIMITED IMPACT (I 10) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Pennit # M-2010-082 (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule I.I 0 <br />Permit # M- 2010 -082 (provide for Amendments and Conversions of existing permits) <br />The application for a Construction :Materials Limited Impact (I 10) Operation Reclamation Permit contains three major parts: ( I ) the <br />application form; (2) Exhibits A -J. Exhibit L. Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit. as required b% <br />the Office, and outlined in Rules 6.1. 6.2. 6.3, 6.5. and 1.6.20)(b): and (3) the application fee. When you submit your application, be sure <br />to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed application form. two (2) copies of <br />Exhibits A -J, Exhibit L. Addendum 1, and appropriate sections ot'6.5 (Geotechnical Stability Exhibit), as required, and a check for the <br />application fee described under (4) below. Exhibits should NOT be bound or in a 3 -ring binder: maps should be folded to 8 112" X I I " or 8 <br />112" X 14" size. I'o expedite processing. please provide the information in the format and order described in this form. <br />2. <br />3. <br />4. <br />5. <br />GI :NI:RAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information described below. <br />Aaplicant/operator or company name (name to be used on permit): LINCOLN COUNTY <br />1.1 Type of organization (corporation, partnership, etc.): COUNTY GOVERNMENT <br />Operation name (pit, mine or site name): JAMACO PIT <br />Permitted acreage (new or existing site): <br />3.1 Change in acreage ( 1 ) <br />3.2 Total Acreaue in Permit Area <br />Fees: <br />4.1 Ne%N Application: <br />Amendment Fee (C.R.S. 34- 32.5 - 125(11)): <br />Primary commoditie(s) to be mined: SAND GRAVEL <br />9.81 permitted acres <br />.01 acres <br />9.8 acres <br />1258.00 application fee <br />tA8_2700 application tee <br />5.1 Incidental commoditie(s) to be mined: 1. Ihsf "I'ons.'vr 2. 1 Ibs.'*I ons :'N•r 3. Ibs :'Tonsfyr <br />4. lbs.jonsivr 5. lbs;Tons'vr <br />5.2 Anticipated end use of primary commodities) to be mined: COUNTY ROAD MAINTENANCE <br />Anticipated end use of incidental commodities) to be mined: N/A <br />