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- w <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 />RECLAMA' <br />STATE OF COLORADO <br />MAY 2 0 2014 <br />DIVISION OF RECLAMATION <br />MINING AND WEV <br />,UCTION MATERIALS <br />AR (112) OPERATION <br />PERMIT APPLICATION FORM <br />COLORADO <br />D I V I S I O N OF <br />RECLAMATION <br />MINING <br />SAFETY <br />CHECK ONE: n There is a File Number Already Assigned to this Operation <br />Permit # M -20#-062W (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M - - - (provide f r Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 peration Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A -S, Addendum 1, any sections of Exhil oit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to include one (1) coml lete signed and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A -S, Addendur 1 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. E x -tibits should NOT be bound or in a 3 -ring binder; maps should be folded to <br />8 1/2" X 11" or 8 1/2" X 14" size. To expedite processing,1 please provide the information in the format and order described in this form. <br />H <br />GENERAL 'PERATION INFORMATION <br />Type or print clearly, IF the sp ce provided, ALL information requested below. <br />1.1 Type of organization (corporation, <br />2. Operation name (pit, mine or site name): <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 commodities) to be mined: SAND <br />5.1 Incidental commodities) to be mined: 1. _ <br />3. / lbs/Tons /yr 4. <br />5.2 Anticipated end use of primary commoditie(s) <br />5.3 Anticipated end use of incidental commoditie( <br />used on permit): HUERFANO COUNTY GOVERNMENT <br />etc.): COLORADO COUNTY <br />VIEW PIT <br />40 permitted acres <br />acres <br />40 acres <br />$2,696.00 application fee <br />$3,342.00 quarry application <br />$2,229.00 amendment fee <br />$2,696.00 conversion fee <br />GRAVEL ROAD BASE BORROW <br />be mined <br />Ibs/Tons /yr 2. 0 / Ibs/Tons /yr <br />Ibs/Tons /yr 5. 0 / lbs/Tons/yr <br />HUERFANO COUNTY ROADS <br />1 to be mined: N/A <br />I <br />