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DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866 -3567 <br />FAX: (303) 832 -8106 <br />STATE OF COLORADO <br />RECEIVED <br />&-/APR 0c, 2015 <br />D bIViSION OF RECLAMATION <br />CONSTRUCTION MATiffi ND SAFETY <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: 0— There is a File Number Already Assigned to this Operation <br />COLORADO <br />DIVISION OF <br />RECLAMATION <br />MINING <br />— St— <br />SAFETY <br />Permit # M1 .980 Q20 (Please reference the file number currently assigned to this operation) <br />0— New Application (Rule 1.4.5) Amendment Application (Rule 1.10) A fm o <br />0— Conversion Application (Rule 1.11) <br />Permit # M 1.980 020 _ (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) complete signed and notarized ORIGINAL and one (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 />4(Z• 1. Avolicant/overator or company name (name to be used on permit): ARS Sand & Gravel <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />2. Operation name (pit, mine or site name): ARS Sand & Gravel <br />3. Permitted acreage (new or existing: site): 82.96 permitted acres <br />3.1 Change in acreage ( +) 22.06 acres <br />3.2 Total acreage in Permit area 105.02 acres <br />4. Fees: <br />4.1 <br />New Application <br />$2,696.00 <br />application fee <br />4.2 <br />New Quarry Application <br />$3342.00 <br />quarry application <br />4.4 <br />Amendment Fee <br />$2,229.00 <br />amendment fee <br />4.5 <br />Conversion to 112 operation (set by statute) <br />$2,696.00 <br />conversion fee <br />Open Pit Sand Gravel <br />5. Primary <br />commoditie(s) to be mined: <br />5.1 <br />Incidental commoditie(s) to be mined: 1. - Ibs /Tons /vr <br />2. / <br />lbs/Tons/vr <br />3. / lbs/Tons/yr 4. / lbs/Tons/vr <br />5. / <br />lbs/Tons/yr <br />5.2 <br />Anticipated end use of primary commoditie(s) to be mined: Construction <br />5.3 <br />Anticipated end use of incidental commoditie(s) to be mined: N/A <br />V AF & Report <br />J Violations <br />MV2015002 1/28/2015 <br />