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('I * <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />s � � ► rr +r <br />RECEIVED <br />MAR 2J2014 <br />CO 1ORADO <br />L <br />1) (V I S 1 0 N 0 F <br />RECLAMATION <br />[)I V1 S 10 N OF E lka'-A.Y.4 i,01 <br />MINING <br />& <br />MUNG A14D SAFETY <br />iy <br />SA FETY <br />CONSTRUCTION MATERIALS <br />LIMITED LN] PACT (110) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />Cl IECK ONE: [X There is a File Number Already Assigned to this Operation <br />Permit 4' M - - - (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4.5) Amendment Application (Rule LI 0) <br />Conversion Application (Rule 1.11) ': % -"" (: 4C ` "`7t' i '_ C e-, t �° Lkj_ <br />Permit 4" M (provide for Amendments and Conversions of existing permits) <br />The application for a Construction :Materials Limited impact (110) Operation Reclamation Permit contains three major parts: (I) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by <br />the Office, and outlined in Rules 6. 1, 6.2,6,3,6.5, and 1.6 2(1)(b); and (3) the application fee. When you submit your application, be sure <br />to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies of <br />Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the <br />application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring binder, maps should be folded to 8 112" X I I" or 8 <br />1/2" X 14" size. To expedite processing, please provide the infort-nation in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information described below. <br />I Aoolicantloperator or company name (name to be used on permit): Cernex, Inc. <br />1.1 Type of organization (corporation, partnership, etc.): Cor0oration <br />2. Operation name (pit, mine or site name): Cernex Sandstone Quarry (formerty,Cemex Silica Quarry) <br />3. Permitted acreage (new or existing site): 9.99 permitted acres <br />Change in acreage 0 acres <br />3.1 9.99 acre," <br />3.2 Total Acreage in Permit Area --- <br />4. Fees: <br />4.1 New Application: $1258.00 application fee <br />Amendment Fee (C.R.S. 34-32.5-(25(11)): $827.00 application fee <br />5. Prima ry commodities) to be mined: Sandstone <br />-f- ' <br />5.1 incidental conimoditie(s) to be mined: 1. )bsjons/y 2. II VTons6ff 3. lbs/ 1'ansrvr <br />4. lbs/Tons! <br />yr 5. lbs/Tonstvr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Cement <br />.Anticipated end use of incidental commoditie(s) to be mined: n/a <br />