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STATE CAF COLOFADO <br />DIVISION OF MINERALS AND GEOLOGY RECEIVED <br />Department of Natural Resources G R� <br />1313 Sherman St., Room 2 IS DIVISION or <br />Denver, Colorado 80203 2 q(0 <br />/ <br />Phone: (303) 866.3567 DEC L'�` y MINERALS <br />FAX: (303) 832.8106 DIVlslao Of & <br />Minerals and Gaofogy GEOLOGY <br />CONSTRUCTION MATERIALS RECLAMATION <br />MINING-SAFETY <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM ✓ Bill Owens <br />Governor <br />Greg E. Watcher <br />Executive Director <br />CRECKQ E: X New Application (Rule 1.4.5) Amendment Application (Rule 1.10�i�r S. Long <br />ivision Director <br />Conversion Application (Rule 1.11) <br />Permit # ly _ -- ✓ (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 form; <br />(2) Exhibits A -S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) camplete signed and no IVO}i O GI 1 Land four (4) copies of the completed I <br />application form, five (5) copies of Exhibits A S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the . <br />application fee described under Section (4) below. E)d&its should NOT be bound or in a 3-ARg binder; maps should be folded to 81f2" X 1 l " <br />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. APgH9ptfaEeratolr ` or company name (name to be used on t>'ermit): Hall-Irwin Corporation ✓ <br />1.1 Type of organization (corporation, parmership, t <br />1.2 I.R.S. Tax ID. No. or Social Security Number: <br />2. <br />Operatign name fuk, mine or site name),: Bernhardt Resource ✓ <br />I 3. <br />Permitted <br />acreage (new or t! -*tia site): <br />286.142 permitted acres <br />3.1 <br />Change in acreage ( +) <br />acres <br />3.2 <br />Total acreage in Permit area <br />_ 286, 22 acres <br />4. <br />Ffts: <br />4.1 <br />New Application <br />$2,344,00 application fee <br />4.2 <br />New Quarry Application <br />$2.906.00 quarry application <br />4.4 <br />Amendment Fee <br />$1.438.00 amendment fee <br />4.5 <br />Conversion to 112 operation (set by statute) <br />$2.344.00 conversion fee <br />5. <br />Mary <br />commodities) to be mined: sand gravel <br />5.1 <br />Incidental commodities) to be mined: 1.Q01 d 5 lbsll' 2. to iL <br />1 200 181-Tons <br />3. 1 lbslTons& 4. 1 lbsiTons& S. <br />/ lbs/Tons/vr <br />5.2 <br />Anticipated end use of primary commoditie(s)tobemined: construction materials <br />5.3 <br />Anticipated end use of incidental commodities) to be alined: <br />