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t <br />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 />Denver, Colorado 80203 <br />CONSTRUCTION MATERIALS <br />C O L O R A DO <br />DIVISION OF <br />Phone: (303) 8663567 <br />REC N <br />FAX: (303) 832 -8106 REGULAR (112) OPERATION <br />M IL NG <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 />Pe M -_- (Please reference the file number currently assigned to this operatiON)ec,mve Director <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Ronald W Cattany <br />Division Director <br />Conversion Application (Rule 1.11) Natural Resource Trustee <br />Permit # M- U/-4 0 IC (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 1 I" 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 />Applicant/oomttor or company name (name to be used on permit): Delta County <br />1.1 Type of organization (corporation, partnership, etc.): Government <br />2. Operation name (pit, mine or site name): North Road Pit <br />3. Permitted acreaee (new or esistine 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 />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: Gravel Sand <br />5.1 Incidental commoditie(s) to be mined: i. - lbs/Tons/vr <br />92.31 permitted acres <br />acres <br />acres <br />$2,696.00 <br />application fee <br />$3,342.00 <br />quarry application <br />$2,229,00 <br />amendment fee <br />$2,696.00 <br />conversion fee <br />2. ( lbs/Tons/vr <br />3. / Ibs/Tons/vr 4. / lbs/Tons/vr 5. ( IW'rons/yr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Road construction aggregate <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />Office of <br />Mined Land Reclamation <br />Denver • Grand ]unction • Durww <br />RECF!` cn <br />FEd <br />Division of iaoon, <br />Mining & Safety <br />Office of <br />Active and Inactive Mines <br />