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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Change in acreage ( +) <br />Department of Natural Resources <br />3.2 <br />1313 Sherman St., Room 215 <br />COL R A D O <br />Denver, Colorado 80203 <br />CONSTRUCTION MATERIALS <br />DIVISION <br />Phone: (303) 866-3567 <br />C LAMATION <br />FAX: (303) 832 -8106 REGULAR (112) OPERATION <br />MINING <br />RECLAMATION PERMIT APPLICATION FORM <br />SAFETY <br />Bit) Ritter, Jr. <br />CHECK ONE: There is a File Number Already Assigned to this Operation Governor <br />Harris D. Sherman <br />Permit # M (Please reference the file number currently assigned to this operatiou)ecenve Director <br />LLNew Application (Rule 1.4.5) -,! Amendment Application (Rule 1.10) Ronald W. Canany <br />Division Director <br />-E_ Conversion Application (Rule 1.11) Natural Resource Trustee <br />Permit # M -1988 -048 - (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) complete signed 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 />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />1. Applicant/overator or company name (name to be used on permit): L.G. Everist, Incorporated <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />2. <br />Operation name (pit, mine or site name): Carr Gravel Resource <br />3. Permitted acreage (new or existing site): <br />3.1 <br />Change in acreage ( +) <br />RP-tQNW <br />3.2 <br />Total acreage in Permit area <br />4. Fees: <br />(Division of Reclalll <br />4.1 <br />New Application <br />, <br />WhIng and Sidet E <br />4.2 <br />New Quarry Application <br />4.4 <br />Amendment Fee <br />4.5 <br />Conversion to 112 operation (set by statute) <br />5. Primary commodities) to be mined: Gravel Sand <br />5.1 Incidental commoditie(s) to be mined: 1. - lbs/Tons/yr <br />1,412.0 permitted acres <br />0 acres <br />1,412.0 acres <br />lX7AW00 application fee <br />quarry application <br />$2.229.00 amendment fee <br />S3691M conversion fee <br />2. / lbs/Tons/vr <br />3. / lbs/Tons/vr 4. / Ibs/Tons/vr 5. / ibs/fons/vr <br />5.2 Anticipated end use of primary commodities) to be mined: Specification aggregates, concrete and asphalt <br />. 5.3 Anticipated end use of incidental commodities) to be mined: <br />Office of office of <br />Mined land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />