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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />New Application <br />Department of Natural Resources <br />application fee <br />4.2 <br />New Quarry Application <br />K <br />quarry application <br />1313 Sherman St., Room 215 <br />Amendment Fee <br />$2,229.00 <br />Denver, Colorado 80203 <br />Phone: 866-3567 <br />�{ <br />iF <br />COLORADOIRECLAMATION <br />s r o N o f <br />(303) <br />U <br />5. Primary commoditie(s) to be mined: Sand and <br />FAX: (303) 832-8106 <br />ININGMINING <br />Incidental commoditie(s) to be mined: l . _ N/A - <br />DIVISION OF RECLAMATION <br />FETY <br />AND SAFETY <br />A <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: Q— There is a File Number Already Assigned to this Operation <br />Permit # M 22d 03()_ (Please reference the file number currently assigned to this operation) <br />LNew Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />0— 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) 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 1 l" 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 />1. Applicant/operator or company name (name to be used on permit): Asphalt Specialties Co., Inc. <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />2. Operation name (pit, mine or site name): Chavers Mining Resource <br />3. Permitted acreage (new or existing site): 70 permitted acres <br />3.1 Change in acreage (+) N/A acres <br />3.2 Total acreage in Permit area 70 acres <br />4. Fees: <br />New Application <br />$2,696.00 <br />application fee <br />4.2 <br />New Quarry Application <br />$3,342.00 <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 />5. Primary commoditie(s) to be mined: Sand and <br />Gravel <br />5.1 <br />Incidental commoditie(s) to be mined: l . _ N/A - <br />lbs/Tons/yr 2. _ / <br />lbs/Tons/yr <br />3. / lbs/Tons/v4. / <br />lbs/Tons/ vr 5. / <br />lbs/Tons/vr <br />5.2 <br />Anticipated end use of primary commoditie(s) to be mined: <br />processed aggregates; asphalt/concrete <br />5.3 <br />Anticipated end use of incidental commoditie(s) to be mined: <br />