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ftATE of OLOR,AD <br />c o <br />DIVISION Of MINERAi.SAND GEOLOGY FEi3 D 9 wUb <br />Deparlmem of tlamat ttesouroa <br />1313 Shemian St., Room 215 Bighk8 of Minerals and Geology COLORADO <br />O <br />Denver, CoOo 803 DIVISION o f <br />O Phoe 003) O 3567 CONSTRUCTON MATERIALS N L S <br />FAX: 303) 8328106 REGULAR (112) OPERATION LL G Y <br />Ne RECLAMATI ON PERMT APPLICATION FORM N <br />Bill t>»em <br />covema <br />C HFC:K ONE There Is a Flle Number Almdp Aalgaed to tbit Operation G" Gem <br />Permit # I (Please reference the file number currently assigned to this operation) F" Di"""Of <br />X New Application (Rule 14 5) Amendment Application (Rule 1 10 Ron&W W. �r <br />PP (R ) tkvnwa Dr�aor <br />Conversion Application (Rule I I I) Na" Reuwa Trustee <br />Permit # _ v1 _l - - _ (provide for Amendmenu and Conversions of ex ang permits) <br />The application foe it Construction Matmals Regular 112 Operation Reciamation Permit eontams three major parts. (1) the application form. <br />(2) Exhibits A -S, Addendum 1, any sections of Exhibn 6.5 (Geotec)mtcal Stability Exhibit; and (3) the application fee Where you subrwtyor <br />application, be sure to include one 0 ) complete an¢ ugl{ljzed Q-%LQ AL and one (1) copy orthe completed application fern, two (2) <br />copies ofExhibns A -S, Addendum I, appropriate sections of6 5 (Gootechaical StabilityExhlblt, and a check for the application fee desenbed <br />under Section (4) below Exhibits should NOT be bound or in a 3 -nng Wider, naps should be folded to 81 /2" X 1 I" or 8111' X 14' we To <br />expodne processing, pleasc provide the information in the formal and order described in this form <br />GENERAL OPERATION INFORMATION <br />Type or print clearly. In the splice provided, A" Infortustiou "ested below. <br />I Apillka—agoomftr ocs m°anX name (nam to ee used a ggMitr Oplebay Norton Industrial Sands, Inc. <br />I I 7)pcoforgannration (corporation, partnerdup, etc) Corporation <br />2 oneratbn <br />name (hit. mine orslte male) _ Jemadt3jin Sand Mine <br />3 Permitted acreage (time v or e:istin site), <br />299.78 permitted acres <br />31 <br />Change in acreage ( +) <br />acres <br />32 <br />'total acreage in Permit aces <br />299.78 acres <br />4 Fees <br />41 <br />New Application <br />S2-344 00 application fee <br />42 <br />New Quarry Application <br />12 906.00 quarry application <br />44 <br />Amendment Fee <br />51.938.00 ametdnnernt fee <br />45 <br />Conversion to 112 operation (set by statute) <br />S2.344,QQ conversion fee <br />3 Mary <br />commodhWa) to be mined sand <br />51 <br />Incidental eominoditie(s) to be mined 1 lbs?oiishrr <br />2 / j¢s�ons/vr <br />3 ! 1bsrron slur 4 J W99 <br />5. 1 lbaff <br />52 <br />Anticipated end use of pnmary coniirioditic(s) to be mined sand pack for oil and water well construction <br />5 3 <br />Anticipated end use of incidental cx movdntie(s) to be mined none <br />olike Of Office of Colorado <br />Mmed land Iteclaerallon Active and Irw1M Mina GmkWcal Survey <br />