2015-05-22_PERMIT FILE - M2015022

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STATE OF COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY Department of Natural Resources 1313 Sherman SL, Room 215 Denver, Colorado 80203 COLORADO Phone: (303) 863567 DIVISION I0F RECLAMATIONMINING FAX: t3031 e32-8106 SAFETY CONSTRUCTION MATERIALS M-2015-022 �� SPECIAL (ll l) OPERATION IVI-2015-022 RECLAMATION PERMIT APPLICATION FORM The application for a Construction Materials Special 111 Operation Reclamation Permit contains four major parts: (1) the application form; (2) Exhibits A -L, Addendum 1, and any sections of Exhibit 6.5 (Geotechnical Stability Exhibit), as required by the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); (3) the application fee; (4) the Performance Warranty and if required a Financial Warranty. When you submit your application, be sure to include one (1) completed. signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies of Exhibits A -L, Addendum 1, appropriate sections of Exhibit 6.5 (Geotechnical Stability Exhibit), as required, a check for the application fee described under (4) below, and the fully executed Performance Warranty and Financial Warranty, if required. Exhibits should NOT be bound or in 3 -ring binders; maps should be folded to 8 2" X I l" or 8 2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, all information described below 1. Applicant/operator or company name (name to be used on the permit): Lary H Inc Type of organization (corporation, partnership, etc.): Corporation 2. Operation name (pit, mine or site name): Bootleg Quarry 3. Permitted acreaee: 4. New Application: 5. Primary commoditie(s) to be mined: Sand, overburden 6. Name of owner to the surface of affected land: Henrylyn Irrigation District 7. Name of owner to the subsurface rights of affected land: Hen ryyn Irrigation District 8. Type of miaine operation: II Surface = Underground n In-situ 9. Location information: The center of the area where the majority of mining will occur: 13.5 permitted Acres $898.00 Application Fee Adams PRINCIPAL MERIDIAN (check one): COUII ams (Colorado) J J I Oth (New Mexico) II Ute SECTION (write number): S 1 TOWNSHIP (write number and check direction): T 1 North ✓ South RANGE (write number and check direction): R 65 East ✓ ✓ West QUARTER SECTION (check one): NE NW SE ✓ SW QUARTER/QUARTER SECTION (check one): NE NW SE SW GENERAL DESCRIPTION: (the number of miles an itection from the nearest town and the approximate elevation): Frnm I nchhtgiPCO travel S miles Past On Fast 168th AyenttP anri 1 mile an tth nn 'ud nn Road. Entrance will be on the east side of Hudson Road at approximately 5,110 feet in elevation. Office of Office of Minted Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines