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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, AU information requested below. <br />Department of Natural Resources <br />1. Applicant/operator <br />1313 Sherrnan St., Room 215 <br />-s G- ra y r) <br />Denver, Colorado 80203 <br />COLORADO <br />Phone: (303) 8663567 CONSTRUCTION MATERIALS <br />D I V 1 S I 0 N o f <br />RECLAMATION <br />FAX: (303) 832 -8106 REGULAR (112) OPERATION <br />MIN ING <br />RECLAMATION PERMIT APPLICATION FORM <br />SAFETY <br />Bill Ritter, Jr. <br />CHECK ONE: ❑ There is a File Number Already Assigned to this Operation Govemor <br />Harris D. Sherman <br />Pj M /' (Please reference the file number currently assigned to this operatiortjecuuve Director <br />1� New Application (Rule 1.4.5) -0 Amendment Application We 1.10) Ronald W. campy <br />laDivision Direcior <br />Conversion Application (Rule 1.11) Natural Resource Trustee <br />Permit # M - (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A -S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to include one (1) comolcte sigLied and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A -S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3 -ring binder; maps should be folded to <br />8 1/2" X 11" or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />Office of Office of <br />Mined Land Reclarnation Denver • Grand )unction • Durango Active and Inactive Mines <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, AU information requested below. <br />1. Applicant/operator <br />or company name (name to be used on permit): R h e- Rloa <br />-s G- ra y r) <br />1a e4!/4{f�� i Zhu <br />1.1 <br />Type of organization (corporation, partnership, etc.): C-0 i- L0r12-y --'dYl <br />M 0A /- <br />2. Operation <br />name (pit, mine or site name): �� <br />3. Permitted acreaee (new or existing site): <br />0 <br />O <br />permitted acres <br />3.1 <br />Change in acreage ( +) <br />acres <br />3.2 <br />Total acreage in Permit area <br />acres <br />4. Fees: <br />4.1 <br />New Application <br />$2,696.00 <br />application fee <br />4.2 <br />New Quarry Application <br />N A <br />quarry application <br />4.4 <br />Amendment Fee <br />amendment fee <br />4.5 <br />Conversion to 112 operation (set by statute) <br />conversion fee <br />5. Primary <br />commodities) to be mined: <br />5.1 <br />rive) __ ZC41 <br />Incidental commodities) to be mined: 1.9 Ibs o1 Z. <br />5an So 0i)6 <br />/ i lb ons/yr <br />3. / Ibs/Tons/vr 4. / 1bs/Tons/yr 5. <br />/ <br />lbs/Tons/yr <br />5.2 <br />Anticipated end use of primary commoditie(s) to be mined: R d a� 0.r1� hi <br />4J�u/ t^Jrj f7�ruchat <br />5.3 <br />Anticipated end use of incidental commodities) to be mined: <br />Office of Office of <br />Mined Land Reclarnation Denver • Grand )unction • Durango Active and Inactive Mines <br />