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STATE OF COLOF ADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Deparhixnt of Natural Resources <br />1313 Sherman SL, Room 215 <br />Dens, Colorado 80203 COLORADO <br />Phone: (303) 8663567 C O N S T R U C T I O N MATERIALS D I V I S I O N OF <br />RECLAMATION <br />FAX: (303) 8324106 REGULAR (112) OPERATION MINING <br />RECLAMATION PERMIT APPLICATION FORM _ <br />SAFETY <br />&— <br />Sol Warr, Jr. <br />CHECK ONE There is a Fik Number Already Assigned to this Operation Governor <br />Haft D. Sherman <br />Peilpq M -� (Please sefereme the file number currently assigned to this operatioa)eaalve Dheew <br />New Application (Rule 1.4.5) J3 Amendment Application (Rule 1.10) a Dl —M �� <br />LiConversion Application (Rule 1.11) mural RemumeTnmhe <br />Permit # M - � !( ?' _ P( / (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 sinned and notarized ORIGINAL and our (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 = be bound or in a 3 -ring binder, maps should be folded to <br />8 1/2" X 11" or 81/2" 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, AU Information requested below. <br />I . Apalicant/ooerator or eomoanv name (name to be used on permit): Delta County <br />1.1 Type of organization (corporation, partnership, etc.): Government <br />2. Owstion <br />name (ant, mine or sift name). North Road Pit <br />3. Permitted <br />acn}k►,e (Dew or mutlft illy: 92.31 <br />permitted acres <br />3.1 <br />Change in acreage N <br />acres <br />3.2 <br />Total acreage in Permit area <br />acres <br />4. Fees: <br />4.1 <br />New Application $2.696.00 <br />application fee <br />4.2 <br />New Quarry Application $3,342.00 <br />quarry application <br />4.4 <br />Amendment Fee $2.229.00 <br />amendment fee <br />4.5 <br />Conversion to 112 operation (set by statute) Sx.696.O0 <br />conversion fee <br />5. primary <br />eommodltie(s) to be Gravel Sand <br />5.1 <br />Incidental commoditie(s) to be mined: 1. lbs/Tons/w 2. / <br />lbslTons/vr <br />3. 1 IbsrTons/vr 4._ / lbs/Tons/vr 5. / <br />Ibs(Tonew <br />5.2 <br />Anticipated and use of primary commodities) to be mined: Road construction aggregate <br />5.3 <br />Anticipated end use of incidental commodities) to be mined: <br />ofte of <br />olrke of <br />Mined Land Radmadon Denver • Grind luncdon • DmW <br />Active and Inacdw Mines <br />RECEIVED <br />FEB 2 4 2014 <br />Division of Reclamation, <br />Mining & Safety <br />