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44 - 2-006 - 003 <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY t---- .,I 4 ��- <br />Department of Natural Resources <br />t 313 Shemm %, Roosts 215 COLORADO <br />Denver, Colorado 80203 DIVISION Of <br />Phone (303) 866.3567 CONSTRUCTION MATERIALS MIN RA L S <br />FAX: (303) 832.8106 REGULAR (112) OPERATION ' G E O O G Y <br />RECLAMATION PERMIT APPLICATION FORM Rf SAFETY�ic "Ie"ic "iN° <br />Bill Owens <br />Governor <br />COCK ONF.: There is a File Number Already Assigned to ibis Operation Rum ell Georp <br />Permit # (Please reference the file number cturrcri ly assigned to this operation) Executive Director <br />New Application (Rule 1.4.5) Amendment Application (Rule 1. f 0) Romld W. Gaany Division Ohector <br />Conversion Application (Rule 1. 11) Natural Rerourm Trustee <br />Permit # �,Lv _- (provide for Amendments and Conversions ofexisting permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application foram; <br />(2) Exhibits A -S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit, and (3) the application fee. When you subnmityour <br />application, be sure to include one (l) cot-nodgAmml and ORIGINAL and one (1) copy of the eompltxcd application farm, two (2) <br />copies of Exhibits A -S, Addendum 1, appropriate sections of6.5 (Geotechnical Stability Exhibit, and a check for the application fee described <br />under Section (4) below. Exhibits should M be band or in a 3 -ring bindta , maps should be folded to 81/2" X i l " or 8 1/2* X 14" sine. To <br />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, ILL Information requested below. <br />1. ra r be an QbI r --rAwlti <br />1.1 Type of organization (corpcuation, partnership, etc.): C <br />.'6r-pozoviio JJ <br />2. OpMtJ"same(gamineor she a ): �Qrkeft — Deits4am &$0utCe -v <br />3. Peralkted acre M e ftw or existing site. <br />3.1 Change in acreage ( +) <br />3.2 ToW acreage in Permit area <br />4. fM: <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. fftNa commo kfe(s) to be mined: <br />RECEIVED <br />SA% 0 6 2006 <br />pivision of Minerals and 6901021 <br />fi�dP� <br />5.1 Incidental commmmoditie(s) to lie mined: 1. Ibs/fotmsfvr <br />permitted acres <br />2. _ / lbsrl'orrsl� <br />3. f lbsrCo m1 s/�r 4. / It►srfonsM - 1 5. l lb !fo <br />5.2 Anticipated end use of primary commodities) to be mined: SinsI %t/C40 � /j1Q earls _ <br />5.3 Anticipated end use of incidental commodities) to be mined: <br />Office of Office of Colorado <br />Mined land Reclamation Active and inactive Mines Geological Survey <br />acres <br />J; . <br />3 acres <br />12,34100 <br />application fee <br />$2.906,00 <br />quarry application <br />$1.93A,00 <br />amendment fee <br />$2.344.00 <br />conversion fee <br />2. _ / lbsrl'orrsl� <br />3. f lbsrCo m1 s/�r 4. / It►srfonsM - 1 5. l lb !fo <br />5.2 Anticipated end use of primary commodities) to be mined: SinsI %t/C40 � /j1Q earls _ <br />5.3 Anticipated end use of incidental commodities) to be mined: <br />Office of Office of Colorado <br />Mined land Reclamation Active and inactive Mines Geological Survey <br />