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RE Cr: rV7D <br />NOV 17 2004 -" <br />CONSTRUCTION MATERIALS ?1i+vision of i ;;;,• �' �:V <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE There is a File Number Already Assigned to this Operation <br />Permit # M (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1 4 5) Amendment Application (Rule 1.10) <br />X Conversion AppEc on (Rule 1 11) <br />Permit # M _-1978- 314_- (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three mayor 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 of6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below Exhibits should LVJ be bound or in a 3 -ring binder, maps should be folded to <br />8 1/2" X 1 I" or 8 1/2' X 14" size. To expedite processing, please provide the information to 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 comnanv name (name to be used onpern ft): King Mountain Gravel, LLC <br />l 1 Type of organization (corporation, partnership, etc.): _Limited Liability Corporation <br />12 1 R.S Tax 1 D No or Social Security Number- 20-1124020 <br />2. Operation name (pit, mine or site same): Kinq Mountain Sand & Gravel Mine ✓ <br />3 Permitted acreage (new or existing site <br />3 1 Change in acreage (+) <br />3 2 Total acreage in Permit area <br />4 Fees. <br />4 1 Ne- Application <br />4 2 New Quarry Application <br />44 Amendment Fee <br />45 Conversion to 112 operation (set by statute) <br />10 <br />permitted acres <br />331 <br />acres <br />341 <br />acres <br />$2,34400 application fee <br />$2,906.00 quarry application <br />$1,938.00 amendment fee <br />$2,34400 conversion fee <br />5 Primary comrnoditie(s) to be mined: sand gravel <br />5 1 Incidental commoditte(s) to be mored: 1 bl/A - lbs/Tonslyr 2 / lbs/Tons/yr <br />3 / lbs/Tons/yr 4 ! lbs/Tons/yr S. / lbs/Tons/yr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: _ Construction Aggregates <br />5 3 Anticipated end use of incidental commoditie(s) to be mined. N/A <br />