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STATE OF COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY , /r 9.1 Department of Natural Resources �'" C 'N 01 �.• acres 1313 Sherman St., Room 215 quarry application COLORADO Denver, Colorado 80203 x.00 rLAMATION Phone: (303) 866-3567 Conversion to 112 operation (set by statute) REC FAX (303) 832 -8106 5. Primary MINING 5.1 Incidental commodities) to be mined: 1. - CONSTRUCTION MATERIALS IbslTons/ REGULAR (112) OPERATION -466T 222014 Ibs/Tons/vr RECLAMATION PERMIT APPLICATION FORM Anticipated end use of primary commodities) to be mined: pDMSION OF RECLAMATM n r t5 MININGANDgA�N CHECK ONE: nv There is a File Number Already Assigned to this Operation R 2910 Q80 Permit # )� _ (Please reference the file number currently assigned to this operation) New Application (Rule 1.4.5) � Amendment Application (Rule 1.10) f Conversion Application 1.11) Permit # -M 2 )10 Q80 _ (provide for Amendments and Conversions of existing permits) The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application form; (2) Exhibits A -S, Addendum 1, any sections of Exhibit 6.5 (Geotechnicai Stability Exhibit; and (3) the application fee. When you submit your application, be sure to include one (1) comMete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies of Exhibits A -S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3 -ring binder; maps should be folded to 8 1/2" X 11" or 81/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, 1ALL information requested below. I Applicauttoperatoror company name (name to be used on permit): Riverside A, c g"tes, LLC 1.1 Type of organization (corporation, partnership, etc.): Limited Liability Company 2. Operatiog name (pit. mine or site name): Existing (Friederichs Pit) Proposed (Friededchs Pit 112) 3. Permitted acreage (new or existing site): 3.1 Change in acreage ( +) 3.2 Total acreage in Permit area 4. Fees: 9.9 permitted acres 9.1 acres 19 acres 4.1 New Application $2,696.00 application fee 4.2 New Quarry Application $3,342.00 quarry application 4.4 Amendment Fee x.00 amendment fee 4.5 Conversion to 112 operation (set by statute) $2,696.00 conversion fee 5. Primary commoditle(s) to be mined: Gravel Sand 5.1 Incidental commodities) to be mined: 1. - lbs/Tons/w 2. / IbslTons/ 3. / lbs)ToWvr 4. / Ibs/Tons/vr 5. / Ibs/Tons/vr 5.2 Anticipated end use of primary commodities) to be mined: Construction Material 5.3 Anticipated end use of incidental commodities) to be mined: