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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />6 <br />R E C F �� � F "F` <br />1313 Sherman St, Room 215 <br />C O L O RA D O <br />Denver, Colorado 80203 <br />DEC <br />Phone. (303) 866 -3567 <br />01 2014 <br />RECLAMATION <br />FAX. (303) 832.8106 <br />M I N I N G <br />DIVISION OF RECLAMATION J <br />SAFETY <br />MININGAND SAFETY OeIC '11V <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECi.AMATION PERMIT APPLICA'll ION FORM <br />C1IECK ONE: F_ There is a File Number Already Assigned to this Operation <br />Permit !t M -20014 061 (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4 5) Amendment Application (Rule 1.10) <br />FL ) <br />Conversion Application (Rule 1.11) <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 maior parts: (1) the application <br />form; (2) Fxhibits 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 notariZc ((_QRIGINAI, 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 fop. <br />the application fee described under Section (4) below, Exhibits should NO :F be bound or in a 3 -ring binder, maps should be folded to <br />8 1 12" X 1 I" or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENF.RAI. OPERATION INFORMATION <br />IYype or print clearly, in the space provided, ALI, information requested belo%N. <br />I Applicant /operator or company name (name to be used on permit). <br />1.1 Type of organization (corporation, partnership, cte.): Corporation <br />2. Oneration name (pit, mine or site name): _Schlosser Pit I <br />3. Permitted acreage (nov or existing site): <br />3.1 Change in acreage (-+) <br />3.2 T031 acreage in Pcrmit area <br />4 Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5 <br />80 permitted acres <br />_ acres <br />8 0 acres <br />.696,00 application fee <br />-WAZ.0-L quarry application <br />4229 amendment fee <br />_ 5 6L7. 96.130 conversion fee <br />Primary commoditic(s) to be mined: Sand Gravel <br />5,1 Incidental commoditie(s) to be mined. I . _ ? <br />t 4.. t Ibs ? ons /vr ` - __ `_ . _. Ib /1 ot1 X[ <br />5.2 Anticipated end use of primary commodilie(s) to be mined: Construction Material <br />5.3 Anticipated end use of incidental commodities) to be mined <br />