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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY RECEIVED <br />C'� V /�® <br />Department of Natural Resources <br />1313 Sherman St, Room 215 <br />Denver, Colorado 80203 I r Q COLORADO <br />Phone (303) $66 -3567 D I V I S t o N O F <br />FAX (303) 832 -8106 RECLAMATION <br />DIVISION Of ",ECI,Ati'A 10N MINING <br />MINING hl +i> SAe c i Y SAFETY <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: F, t There is a File Number Already Assigned to this Operation <br />Permit 9 M2DO6 Q42 (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4.5) Amendment Application (Rule LI0) <br />Conversion Application (Rule 1.1 1) <br />Permit 9 M 2.006 Q42 _ (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 (t) 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 of6.5 (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 />8 112" 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 />1. Applicant /operator or company name (name to be used on permit): _MMM Partnership <br />1.1 Type of organization (corporation, partnership, etc.): Partnership <br />2. Operation name (nit, mine or site name): MMM Partnership Gravel Pit <br />3 Permitted acreage (new or existing site): <br />9.9 <br />permitted acres <br />3.1 <br />Change in acreage ( +) <br />17.9 <br />acres <br />3.2 <br />Total acreage in Permit area <br />27.8 <br />acres <br />4. Fees. <br />4.1 <br />New Application <br />$2.696.00 <br />application fee <br />4.2 <br />New Quarry Application <br />$3,342.00 <br />quarry application <br />4.4 <br />Amendment Fee <br />$2.229.00 <br />amendment fee <br />4.5 <br />Conversion to 112 operation (set by statute) <br />$2.696.00 <br />conversion fee <br />5 <br />Primary commoditie(s) to be mined: Sand Gravel Borrow <br />5.1 Incidental commoditie(s) to be mined: 1. NSA - Ibs /Tons/vr 2 ! lbs/Tons/vr <br />3. / Ibs /Tons /yr 4. / Ibs /Tons/vr 5. ! Ibs/Tons/yr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Road construction <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />