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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />RECEIVED <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 COLORADO <br />I ON OF <br />D IV Phone: (303) 866-3567 OCT 01 2015 RECLAMATION <br />FAX: (303) 832-8106 MINING <br />DIVISION OF RECLAMATION SAFETY <br />MINING AND -AFETY <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM ii <br />CHECK ONE: tr 1-- There is a File Number Already Assigned to this Operation <br />Permit # M - 1299 060 (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M 1999 (160 - (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 />✓ Compliance <br />✓ NO Violations <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />1. Applicant/operator <br />or company name (name to be used on permit): Las Animas County <br />1.1 <br />Type of organization (corporation, partnership, etc.): County Gov't <br />2. Operation <br />name (pit, mine or site name,): Yocam Pit (removed "Gravel" on 9-22-2015) <br />I Permitted acresee (new or existing site): 9.9 permitted acres <br />3.1 <br />Change in acreage (+) 57.4 acres <br />3.2 <br />Total acreage in Permit area 67.3 acres <br />4. Fees: <br />4.1 <br />New Application $2.696.00 application fee <br />4.2 <br />New Quarry Application $3,342.00 quarry application <br />4.4 <br />Amendment Fee $2.229.00 amendment fee <br />4.5 <br />Conversion to 112 operation (set by statute) $2.696.00 conversion fee <br />5. Primary <br />commoditie(s) to be mined: road base rip rap <br />5.1 <br />Incidental commoditie(s) to be mined: 1. none lbs/Tons/yr 2. / lbs/Tons/xr <br />3. / lbs/Fons/vr 4. / lbs/Tons/v5. / lbs/Tons/yr <br />5.2 <br />Anticipated end use of primary commoditie(s) to be mined: maintenance and repair of County roads <br />5.3 <br />Anticipated end use of incidental commoditie(s) to be mined: maintenance and repair of Couty Rd ROW <br />✓ Compliance <br />✓ NO Violations <br />