2015-05-27_REVISION - M2002109

• Permit No: M2002109
• IBM Index Class Name: REVISION
• Doc Date: 5/27/2015
• Doc Name: Notice AR01
• From: DRMS
• To: A. Blasi & Sons Trucking
• Type & Sequence: AR1
• Email Name: TOD
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGr I t C toV r T
Department of Natural Resources
1313 Sherman Room 215 FOR SCANNING RECEIVED
Denver, Coloraddoo 80203 DIV( s r o N OF
Phone: [phone] nn M I N E RAL S
FAX: [phone] OCT
2 3 2002 &
GEOLOGY
CONSTRUCTION MATERIALSplvision of Minerals and Geology RECLAMATION
MINING -SAFETY
LIMITED IMPACT (110) OPERATION
Bill Owens
RECLAMATION PERMIT APPLICATION FORM Governor
Greg E. Walcher
Executive Director
Michael B. Long
fton Director
CHECK ONE: _ New Application (Rule 1.4) Conversion Application (Rule
Amendment Application (C.R.S. 34-32.5-110)
Permit #. M -�? W9 (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the application form;
(2) Exhibits A -J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and 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); and (3) the application fee. When you submit your application, be sure to include one (1) complete signed and
notarized IVORY ORIGINAL and one (1) copy of the completed Ivory application form, two (2) copies of Exhibits A -J, Exhibit I-, Addendum 1, and
appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the application fee described under (4) below. Exhibits should
NOT be bound or in a 3 -ring binder; maps should be folded to 8 12" 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.
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, ALL information described below.
Applicant/operator or company name (name to be used on permit): A. Blasi & Son Trucking & - Ear thrnoyi ng
1.1 Type of organization (corporation, partnership, etc.)_
Corporation Inc.
1.2 I.R.S. Tax ID No. or Social Security Number:
Operation name (pit, mine or site name ,ucharas: 'Pit
Permitted acreage (new or elidstin site): _A _ 5 permitted acres
3.1 Change in acreage (+) acres
Total Acreage in Permit Area 9.5 acres
4. Fees:
4.1 New Application: $1,094.00 application fee
Amendment Fee (C.R.S. 34-32.5-125(Ii)): $719.00 application fee
4.2 Conversion Fee (from 110d to 110 $875.00 conversion fee (Rule 1.11.2(2))
Primary commoditie(s) to be mined: 1 112 " RB
5.1 Incidental commoditie(s) to be mined: 30, 000/ lbs/Tons/fir 2. / lbs/Tons/yr 3. / lbs/Tons/yr
4. ! lbs/Tons lyr 5. ! lbs/Tons/yr
5.2 Anticipated end use of primary commoditie(s) to be mined:
5.3 Anticipated end use of incidental commoditie(s) to be mined: