Laserfiche WebLink
lifillilillifill oRECE 9VED <br />9" NOV <br />REGULAR (112 ) PERMIT MlNBO LAND <br />APPLICATION FORM RECLAMATION DIVISION <br />This form contains two major parts: (1) General Operation Information and (2) Exhibits <br />A -P. When you submit your application, be sure to include four signed copies of the <br />General Operation Information, four copies of Exhibits A -P, and ak for the <br />application fee described under (4) below. To expedite processing, please provide the <br />information i n- the - format - and - order -described i n -thi s- form_ -m =r1D C/ <br />GENERAL OPERATION INFORMATION A/, 3y 5. (-'o <br />Type or print clearly, in the space provided, all information described below. <br />1. <br />Applicant /Operator Name: WESTERN AGMEGATBS, INC. <br />❑ <br />2. <br />Operation Name (Pit, mine or site name): Lightweight <br />Aggregate Project <br />3. <br />Application type: Regular (112) Permit Operation. <br />East <br />4. <br />Application Fee for Permitted Acreage* <br />$ 108.04 permitted <br />acres. <br />QUARTER SECTION (check one): <br />($50.00 + $15.00 /acre, ist. 50 acres; <br />NW <br />❑ SE <br />$10.00 /acre, 2nd. 50 acres; $5.00 /acre, 3rd. 50 acres; <br />QUARTER /QUARTER SECTION (check one): <br />Q NE Q <br />$1.00 /acre, any additional acreage; maximum fee of <br />❑ SE <br />❑ SW <br />$2,000.00).* <br />_ <br />Note permitted acreage and application fee and <br />(miles and direction approximately 5 <br />attach a check for this amount when you file. <br />$ 1 345.00 application fee. <br />5. <br />Substance(s) to be mined (e.g., gold /silver /gravel): <br />shale <br />6. <br />Owners(s) of Substance to be Mined <br />(check applicable box(s)): ® Private 0 <br />State O Federal O Indian <br />7. <br />Owner(s) of Record of Affected Land <br />(check applicable box(s)): ® Private p <br />State Q Federal Q Indian <br />B. <br />Type of Mining Operation <br />(check applicable box(s)): ® Surface 0 <br />Underground ❑ In -situ <br />9. <br />Location Information. The center of the area where the majority of mining will <br />occur lies in: <br />COUNTY: Jefferson <br />PRINCIPLE MERIDIAN ck one): ® 6th (Colorado) ❑ 10th (New Mexico) O Ute <br />TOWNSHIP (write number and check direction): <br />T_ <br />❑ <br />North <br />® South <br />RANGE (write number and check direction): <br />R 70 <br />❑ <br />East <br />® West <br />SECTION (write number): <br />S 5 <br />QUARTER SECTION (check one): <br />®--NT— ❑ <br />NW <br />❑ SE <br />O SW <br />QUARTER /QUARTER SECTION (check one): <br />Q NE Q <br />NW <br />❑ SE <br />❑ SW <br />GENERAL DESCRIPTION: <br />_ <br />(miles and direction approximately 5 <br />miles south of Boulder, <br />Colorado <br />from nearest town and <br />approximate elevation) alonct Colorado Highway-23 at an elevation of about <br />5950 feet <br />* If the operator is a unit of State or county government, an application fee is not <br />required. A fraction of an acre must be counted as one acre for fee calculation. <br />