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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY AM-091 <br />of Natural Resources <br />Department Pt <br />1313 Sherman St., Room 215 � COLORADO <br />A <br />D e n v e r , C o l o r a d o 80203 t IAY 2 7 D I V I S I O N OF <br />Phone: (303) OW3567 2008 RECLAMATION <br />FAX: (303) 932 -9106 CONSTRUCTION MATERIALS OfVlsio� or Kt3C)ama MINING <br />REGULAR (112) OPERATION Mining and SAFTY <br />RECLAMATION PERMIT APPLICATION FORM `Safety <br />Bill Ritter, Jr. <br />Governor <br />ME&K ONE There is a File Number Already Assigned to this Operation Fw i$ o Sherman <br />Executive Director <br />Permit # M -1997_ 058 __ (Please reference the file number currently assigned to this operative W. Cattany <br />New Application (Rule I A.5) X Amendment Application (Rule 1.10) O'vw— " <br />Natural R%ource Trustee <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 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) oomlglete signed and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A -S, Addendum I, 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, naps should be folded to <br />8 112" X i l" or 8 1/2" X 14" size. To expedite processing, please provide fire information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, In the space provided, ,I Information requested below. <br />1. Au»lieantlonerator or cottmaanv nawe (name to be used 99 permit): Hall -Irwin Corporation <br />1.1 Type of organization (corporation, partnership, ctc.): Corporation <br />2. Operation name (nit mine or site name): Baseline Resources <br />3. Permitted acreatte (new or eh ' e $ite): <br />3.1 Change in acreage ( +) <br />3.2 Total acreage in Permit area <br />209.6 permitted acres <br />0 acres <br />209.6 acres <br />4. <br />4.1 New Application 11M.00 6.00 application fee <br />4.2 New Quarry Application 53342.00 quarry application <br />4.4 Amendment Fee $2.229.00 amendment fee <br />4.5 Conversion to 112 operation (set by Statute) S2 b9fti00 conversion fee <br />5. Pri amy commoditie(s1 to be mined: grovel sand _ <br />5.1 Incidental connnoditie(s) to be mined: 1. Ibs/fons/vr 2. / Ibs/Tons/vr <br />3. / lbs/fons/vr 4.- / Ibs/rons/vr 5. <br />5.2 Anticipated end use of primary commodities) to be mined: Construction materials <br />5.3 Anticipated end use of incidental commodities) to be mined <br />Office of Office of <br />Mined Land Reclamation Denver - Grand junction - DUMW Active and Inactive Minor <br />