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DIVISION OF RECLAMATION, MINING AND SAFETY <br />STATE OF COLORADO <br />Department of Natural Resources <br />1313 Sherman St, Room 215 <br />Denver, Colorado 80203 _ J DCOLORADO <br />Phone: (303) 866 -3567 r LE 6 7 2� 14 RECLAMATION <br />FAX: (303) 832 -8106 MINING <br />Division of Reclamation, <br />Mining & Safety SAFETY <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: 0 There is a File Number Already Assigned to this Operation <br />Permit # MIX8 Q71 (Please reference the file number currently assigned to this operation) <br />0— New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />0— Conversion Application (Rule 1.11) <br />Permit # M 1998 Q71 - (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 /operator or company name (name to be used on permit): Richard <br />1.1 Type of organization (corporation, partnership, etc.): Individual <br />2. Operation name (pit, mine or site name): Fryrear Pit #2 <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 />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: Gravel Sand Clay <br />5.1 Incidental commoditie(s) to be mined: 1. - Ibs /Tons /yr <br />3. / lbs /Tons /yr 4. / lbs /Tons /yr <br />5.2 Anticipated end use of primary commoditie(s) to be mined:_ <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />L'/ A Fe �-� <br />rear <br />40.0 permitted acres <br />40.0 acres <br />80.00 acres <br />$2,696.00 application fee <br />quarry application <br />,$2,229.00, amendment fee <br />$2,696.00 conversion fee <br />2. / lbs /Tons /yr <br />5. / lbs /Tons /yr <br />