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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />C2 1= V <br />Department of Natural Resources <br />Change in acreage ( +) <br />1313 Sherman St., Room 215 <br />3.2 <br />Denver, Colorado 80203 <br />COLORADO <br />Phone: (303) 866.3567 CONSTRUCTION MATERIALS <br />D I V I S ION O F <br />RECLAMATION <br />FAX: (303) 832 -8106 REGULAR (112) OPERATION <br />MINING <br />RECLAMATION PERMIT APPLICATION FORM <br />SAFETY <br />4.2 <br />Bill Ritter, Jr. <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Governor <br />Amendment Fee <br />Harris D. Sherman <br />Permit # M - - -_ (Please reference the file number currently assigned to this operatiolt3ecutive Director <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Ronald W. Canany <br />Division Director <br />Conversion Application (Rule 1.11) <br />Natural Resource Trustee <br />Permit # M - - - (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A -S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A -S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits 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, 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 requested below. <br />1. ApOicant/overator or company name (name to be used on permit): Albert Frei and Sons. Inc. <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />2. Operation name (pit, mine or site name): Hatchery Pit <br />3. Permitted acreage (new or existing site): <br />C2 1= V <br />3.1 <br />Change in acreage ( +) <br />Il <br />3.2 <br />Total acreage in Permit area <br />Nf1V 4 2014 <br />4. Fees: <br />DIVISION OF RECLAMATION <br />4.1 <br />New Application <br />MINING AND SAFETY <br />4.2 <br />New Quarry Application <br />4.4 <br />Amendment Fee <br />4.5 <br />Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: Gravel <br />Sand Borrow <br />5.1 <br />Incidental commoditie(s) to be mined: 1. <br />- lbs/Tonslvr <br />53.17 permitted acres <br />acres <br />53.17 acres <br />$2,696.00 <br />application fee <br />$X34UR <br />quarry application <br />$2rRIUIR <br />amendment fee <br />$U96AR <br />conversion fee <br />2. / lbs /Tons /vr <br />3. / lbs/Tons /yr 4. / lbs/Tons /yr 5. / lbs/Tons /vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: 5pecif ication aggregates, fill <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />