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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFE <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colo 886 80203 <br />Phone: (303) <br />FAX: (303) 832 -8106 <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />COLOADO <br />ID" �' C rl Sp1�AARTION <br />MINING <br />SAFETY _ <br />this Operation <br />There is a File Number Already erasion) <br />CE -' Assigned to (please reference the file number currently assigned to this op <br />Permit # M - I Amendment Application (Rule 1.10) <br />D— New Application (Rule 1.4.5) 91— Conversion Application (Rule I A 1) <br />(provide for Amendments and Conversions of existing permits) <br />Permit # M -_-- --= 1 the application <br />Regular 112 Operation Reclamation Permit contains three major Cation fee. When you <br />Exhibit; and (3) feted <br />The application for Construction 1, any sections of Exhibit 6.5 (Geotechnical Stability . d ORIGINAL and one (1) copy of the come <br />form; (2) Exhibits A -S, Addendum 1, any com fete si ed and notarize <br />submit your application, be sure to include one (1) sections of 6.5 (Geoteclvucal Stability Exhibit, hould be, folded to <br />two 2 copies of Exhibits A -S, Addendum 1, appropriate binder, map <br />application form, () P <br />the app a recessing, please provide the information in the format and order described in this form. <br />application fee described under Section 14) below. Exhibits should NOT be bound or in a -ring <br />8 1/2" X 11" or 8 1/2" X 14" size. To expedite P <br />GENERAL OPERATION INFOKNiA 1 ivly <br />.,Ant clearly, in the space provided, ALL information requested below. <br />rr �c- t.t HflLlF -HLI� /,01e� --- <br />1. <br />AID lican o rater or Con- an name name to be used °n� t ©��T /Q <br />1.1 Type of organization (corporation, partnership, etc.: (- P <br />2 Operation na Be (pit, mine or site na-M-2 : <br />3. Permitted acreage (new or misting site): <br />3.1 Change in acreage H <br />3,2 Total acreage in Permit 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. prima -v commoditie(s) to be mined: S'%iNA S T17N g <br />5.1 Incidental commoditie(s) to be mined: 1. lbs/Tons/vr <br />3 / lbs/Tons/yr 4. / lbs/Tons/vr <br />tp permitted acres <br />acres <br />acres <br />$2,696.90— application fee <br />$3342-00 quarry application <br />2$ 229,00 amendment fee <br />_$2&96.00 conversion fee <br />2. / lbs/Tons/vr <br />5. / Ibs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: D)ZieDAti T/ V4-7- - <br />5.3 Anticipated end use of incidental commodities) to be mined: <br />