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R <br />iiuuiinmmui <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />%(1' �� <br />Department of Natural Resources <br />(l�__ �J <br />1313 Sherman Room 215 <br />Denver, Colorado do 80203 <br />n � f4 <br />�+ <br />Phone (303) 866 3567 <br />j! <br />FAX. (303) 832-8106 <br />1.2 <br />CONSTRUCTION MATERIALS <br />0 P:(7,FIVCE D <br />, rm rats & Geology <br />IPWIF!-, <br />DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />REGULAR (112) OPERATION <br />A 1� `, Rov Romer <br />/UT�) RECLAMATION PERMIT APPLICATION FORM Governor <br />James S. Lochhead <br />Executive D:recior <br />Michael B Long <br />Division Director <br />CHECK ONE: New Application (Rule 1.4.5) y Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M -1 - Or;n - (provide for Amendments and Conversions of existing <br />permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains <br />three major parts: (1) the application form; (2) Exhibits A -S, Addendum 1, any sections of <br />Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete signed and notarized IVORY ORIGINAL and four (4) <br />copies of the completed Ivory application form, five (5) copies of Exhibits A -S, Addendum 1, <br />appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application fee <br />described under Section (4) below. Exhibits should NOT be bound or in a 3 -ring binder; maps <br />should be folded to 8 1/2" X 11" or 8 1/2" X 14" size. To expedite processing, please provide <br />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. <br />Applicant <br />Rymnnd <br />/operator or company name (name to be used on permit): <br />F Anil Rnhprt W dal 1 arrnr+p <br />1.1 <br />Type of organization (corporation, partnership, <br />etc.): indi- iduals <br />1.2 <br />I.R.S. Tax I.D. No. or Social Security Number: <br />2. <br />Operation name (pit. mine or site name): Dellacroce <br />Pi <br />3. <br />Permitted acreage (new or existing aite): <br />14.6 (11.7) permitted acres <br />3.1 <br />Change in acreage ( +) <br />+131 .4---053:6) acres <br />3.2 <br />Total acreage in Permit area ( "affected area ") <br />1-4r,(64.8) acres <br />4. <br />Fees: <br />4.1 <br />New Application <br />$1.875.00 application fee <br />4.2 <br />New Quarry Application <br />52.325.00 quarry application <br />4.3 <br />Milling Application (Non -DMO) <br />$3.100.00 milling application <br />4.4 <br />Amendment Fee <br />$1,550.00 amendment fee <br />4.5 <br />Conversion to 112 operation (set by statute) <br />$1.875.00 conversion fee <br />5. <br />Prima ry <br />commodities) to be mined: Aggregate <br />,1 <br />150,000 tons /year_ <br />5.1 <br />Incidental commoditie(s) to be mined: 1. <br />lbs /Tons /vr <br />2. / lbs /Tons /yr 3. <br />/ lbs /Tons /vr <br />4. / lbs /Tonsfyr 5. <br />/ 1bs/Tons /yr <br />5.2 <br />Anticipated end use of primary commodities) to <br />be mined: .na.,J base <br />5.3 <br />Anticipated end use of incidental commodities) <br />to be mined: <br />