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L__j <br />r-, <br />LJ <br />r-� <br />STATE OF COLORADO <br />�v <br />1. <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1.1 Type of organization (corporation, partnership, etc.): LLC <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />COLORADO <br />Phone: (303) 866 -3567 <br />D IV IS I ON O r <br />RECLAMATION <br />FAX: (303) 832 -8106 <br />MINING <br />' <br />3. <br />SAFETY <br />CONSTRUCTION MATERIALS „LL, G I � V J <br />REGULAR (112) OPERATION <br />�+( <br />RECLAMATION PERMIT APPLICATION FORM JAIN 12 lr <br />CHECK ONE: ✓ There is a File Number Already Assigned to this Operation DIVISION OF RECLAMATION <br />Permit # M 19_80 183 (Please reference the file number currently assigned to t 11.10) is operEM HiNG AND SAFETY <br />New Application (Rule 1.4.5) Amendment Application (Rul <br />Conversion Application (Rule 1.11) a <br />Permit # M - 1980 183 (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three ajor parts: (1) the application <br />form; (2) Exhibits A -S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3)tthe application fee. When you <br />submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and �ne (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 />' <br />1. <br />Applicant/operator or company name (name to be used on permit): Brannan Sand and Gravel Company, LLC <br />1.1 Type of organization (corporation, partnership, etc.): LLC <br />' <br />2. <br />Operation name (pit, mine or site name): Pit 29 <br />' <br />3. <br />Permitted acreage (new or existing site): <br />3.1 Change in acreage ( +) <br />178.42 <br />1.1 <br />permitted acres <br />acres <br />3.2 Total acreage in Permit area <br />179.52 <br />acres <br />4. <br />Fees: <br />4.1 New Application <br />52.696.00 <br />application fee <br />4.2 New Quarry Application <br />53.342.00 <br />' quarry application <br />4.4 Amendment Fee <br />$1,229.00 <br />amendment fee <br />' <br />4.5 Conversion to 112 operation (set by statute) <br />52.696.00 <br />conversion fee <br />5. <br />Primary commoditie(s) to be mined: Aggregate Sand <br />' <br />5.1 Incidental commoditie(s) to be mined: 1. <br />lbs/Tons/vr 2. <br />Ibs/Tons/vr <br />3. / Ibs/Tons/vr 4. / <br />Ibs/Tons/vr 5. <br />/ <br />lbs/Tons/vr <br />' <br />5.2 Anticipated end use of primary commoditie(s) to be mined: <br />Asphalt and Concrete <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />Fill <br />J AF & Report <br />' <br />J MV- 2014 -036 10/29/2014 <br />