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DIVISION OF ItEaAMA17ON, MINING AND SAFETY <br />Departrnent of Natural Resourm <br />COLORADO <br />D I V I S I O N OF <br />RECLAMATION <br />MINING <br />SAFETY <br />CONSTRUCTION MATERIALS Wov, —'--- <br />'�fi'kmrr, h <br />LIMITED IMPACT (110) OPERATION JUL 13 2009 Harts DD n <br />RECLAMATION PERMIT APPLICATION FORkv*'m f Woo - Dlrean, <br />M*n9 andSaf W. <br />There is a File Number Already Assured to this Operation NautntlResoweerrufte <br />2c)dq _ a 5"3 <br />Permit # M -� __ (Please reference the umber 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 11 �' ! (provide for Amendments and Conversions of existing permits) <br />1313 Shemran SL, Room 215 <br />Deriver, Colorado 80203 <br />Phone: (303) SW3567 <br />FAX: (303) 8328106 <br />A -Z609-05,3 <br />Ofiml��W W, be& <br />The application for a Construction Materials Limited Impact (I 10) Operation Reclamation Permit contains three major parts: (I) ft <br />application form; (2) Exhibits A -J, Exhibit L, Addendum 1, any sections o£Exhlbit 6.5 and Geotechnical Stability Exhibit, as required <br />by 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 <br />sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies <br />of Exhibits A -J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for <br />the application fee described lender (4) below. Exlubita should x.03 be bound or in a 3 -ring binder, maps should be folded to 8112" X <br />11" 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 described below. <br />L AvDllcant/OAerator or comuaaYname (game to be used on Permit): <br />1.1 Type of organization (corporation, puff ship, etc): Robins Construction Company LLLP. <br />2. Operation name (alt: mine or site name): Robins Rock Pit <br />3. Permitted acreage (new or ezist n site), <br />3.1 Change in acreage ( +) <br />3.2 Total Acreage in Permit Area <br />4. E: <br />4.1 New Application: <br />Amendment Fee (C.R.S. 34- 32.5- 125(In): <br />4.2 Conversion Fee (from 114d to 110 $2,6%.00 conversion fee (Rule 1.11.2(2)) <br />5. Primary eommodlfie(s) to be mined: <br />9.7 permitted acres <br />0 acres <br />9.7 acres <br />$1.25&00 application fee <br />$827.00 application fee <br />S.I Incidental commoditie(s) to be mined: 1. / IN/Tons(yr 2. 1 Ibs/Tons/vr 3. / Ibsrl o <br />4. / IbatTons/yr 5. / lbafrona/vr <br />5.2 Anticipated end use of primary commodide(s) to be mined: <br />Anticipated end use of incidental commodities) to be mined: <br />Office of Office of <br />Mined land Redanwtion Deliver • Grand 1unQion • Durango ActMe and l Office Of a Mines <br />