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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />application fee <br />Department of Natural Resources <br />quarry application <br />1313 Sherman St., Room 215 <br />amendment fee <br />R A D O <br />Denver Colorado 80203 <br />Phone: (303) 866.3567 CONSTRUCTION MATERIALS <br />DIVISION <br />FAX: (303) 832 -8106 REGULAR (112) OPERATION <br />N I N413 <br />RECLAMATION PERMIT APPLICATION FORM <br />SAFETY <br />Bill Ritter. Jr. <br />CHECK ONE: ❑ There is a File Number Already Assigned to this Operation Govemm <br />Hams D. Sherman <br />P vet dW_'�W% (Please reference the file number currently assigned to this operatio4ewtive DirecW <br />New Application (Rule 14.5) Amendment Application (Rule 1.10) Ronald W. canany <br />Division Director <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 mayor parts: (1) the application <br />fort; (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 />B 1/2" X I I" or S 1/2" X 14" size. To expedite processing, please provide the information in the format and order described to this form. <br />GENERAL OPERATION rNFORMATION <br />Type or print clearly, in the space provided, A�L information requested below. <br />I. Apli icant/operator or company name (name to be used on permit): Connell Resources, Inc. <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />2 <br />Operation name pit, mine or site name): Connell Carr Pit <br />3. Permitted acreage (new or existing site): <br />3.1 Change in acreage ( +) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />45 Conversion to 112 operation (set by statute) <br />5 <br />RECEIVED <br />,JAN 0 6 2014 <br />DIVISION OF RECLAMATION <br />MININ13AND SAFETY <br />456.0 permitted acres <br />0 acres <br />456.0 acres <br />$2,696.00 <br />application fee <br />53,342.00 <br />quarry application <br />52.229.00 <br />amendment fee <br />S2.6%.00 <br />conversion fee <br />Primary commodities? to be mined: sand gravel <br />5.1 Incidental commoditie(s) to be mined: 1. Na lbs/Tons/vr 2. / lbs/Tons/yr <br />3. / lbs/Tons/vr 4. / lbs/rons/vr 5. / lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Construction Materials <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: n/a <br />Office of Office of <br />Mined Land Reclamation Denver • Grand junction • Durango Active and Inactive Mines <br />