2014-08-19_REVISION - M1995008 ‎(3)‎

• Permit No: M1995008
• IBM Index Class Name: REVISION
• Doc Date: 8/19/2014
• Doc Name: Notices AR01
• From: DRMS
• To: Various
• Type & Sequence: AR1
• Email Name: TC1
• Media Type: D
• Archive: No

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xYYLiLATI�N FORM
CHECK ONE: X New Application Mule 1.4.5)
Conversion Application (Rule 1.11)
R�U'�I »gip
FEB 0 3 N95
AmendI4 OcmV(xW i.lol
Permit No. M- (provide for amendments and conversions of existing
permits)
The application for a Regular Operation Reclamation Permit contains three major parts: (i)
the application form; (2) Exhibits A -S and Geotechnical Stability Exhibit; and, (3) the
application fee. When you submit your application, be sure to include one (1) signed and
notarized original and four (4) copies of the application form, five (5) copies of Exhibits
A -R and any required sections of Exhibit S and the Geotechnical Stability Exhibit, and a
check for the application fee described under Section (16) on Page 3. Exhibits should not
be bound or in a 3 -ring binder; maps should be folded to a 1/2" x 11" or 8 1/2" X 14" size.
To expedite processing, please provide the information in the format and order described
in this form, G
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, all information described below.
1. Applicant /operator or company name (name to be used on permit): -- - -
Fremont Pavin, & Redi -Mix Inc.
1.1 Type of organization (corporation, partnership, etc.): Cornoration
1.2 I.R.S. Tax ID No. or Social Security Number: 84-058T8_729
2.
Operation name (pit, mine or site name):
Florence Pit
3.
Permitted
acreage (new or existing site)
14.4± permitted acres
3.1
Change in acreage (+ or -)
acres
3.2
Total acreage in Permit area
± acres
4.
Fees:
4.1
New Application
$1.875.00 application fee
4.2
New Quarry Application
$2,325.00 quarry application
4.3
Milling Application (Non -DMO)
$3,100.00 milling application
4.4
Amendment Fee
$1,550.00 amendment fee
4.5
Conversion to 112 operation (set by statute) $1,500.00 conversion fee
5.
Primary
commodities) to be mined:
sand and gravel
6.
Name
of owner of surface of affected land:
Refer to Exhibit P
7.
Name
of owner of subsurface rights of affected
land: Refer to Exhibit P
If 2 or more owners, refer to Exhibit O.
a.
Type
of mining operation: X Surface — Underground -.,_ In -situ
9.
Location Information: the center of the area
where the majority of mining will
occur
lies in:
COUNTY: Fremont
PRINCIPAL MERIDIAN (check one): X 6th (Colorado) 10th (New Mexico) Ute
SECTION (write number): — S 75
TOWNSHIP (write number and check direction): T - 9 North South
RANGE (write number and check direction): R = East West
QUARTER SECTION (check one):
)L N$ iaw ss sw
QUARTER /QDARTER SECTION (check one): — NE X NW SE SW
GENERAL DESCRIPTION (miles and direction fronearest town and approximate
elevation):
Anproxinately 0-25 mjlP nrrth of Florence
A22roxir*ateltir 5,250 ft, elevation.
ORIGINAL