_REVISION - M2009010

• Permit No: M2009010
• IBM Index Class Name: Revision
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION,RAINING AND SAFELY
Departrnent of Natural Resources
1313 Sherman St,Room 215
Denver,Colorado 8=3 0 i 0'o N of
Phone:[phone] RECLAMATION
FAX:[phone] M I N I NG
SAFETY
CONSTRUCTION MATERIALS
REGULAR(112)OPERATION
RECLAMATION PERMIT APPLICATION FORM
CHECK ONE: There is a File Number Already Assigned to this Operation
Permit# M - - - (PIease reference the file number currently assigned to this operation)
New Application(Rule 1.4.5) Amendment Application(Rule 1.10)
Conversion Application(Rule 1.11)
Permit# M y - (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts:(1)the application
form;(2)Exhibits A-S,Addendum 1,any sections of Exhibit 6.5(Geotechnical Stability Exhibit;and(3)the application fee. When you
submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and one (1)copy of the completed
application form,two(2)copies of Exhibits A-S,Addendum 1,appropriate sections of 6.5(Geotechnical Stability Exhibit,and a check for
the application fee described under Section(4)below. Exhibits should NOT be bound or in a 3-ring binder;maps should be folded to
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.
GENERAL OPERATION INFORMATION
Tyke or print clearly,in the space provided,ALL information requested below.
1. Applieantloyerstor or company name(name to be used on permit): r1 C C 07 c e t AC iJ � �iafa+ �v10� Pk y ie�� 1 a a;
1.1 Type of organization(wrporation,partnership,etc.): 1'� ^
2. Operation name(nit mine or site name): Eu'E
3. Permitted acreage(new or ezistine site): G permitted acres
3.1 Change in acreage(+) y acres
3.2 Total acreage in Permit area S Q___ acres
4. Fees:
4.1 New Application $2,696.00 application fee
4.2 New Quart'Application $3,342.00 quarry application
4.4 Amendment Fee $2,229.00 amendment fee
4.5 Conversion to 112 operation(set by statute) $2,696.00 conversion fee
5. Primary commodities)to be mined: kc\
5.1 Incidental commoditie(s)to be mined: 1. +'%r f - lbs/Tons/vr 2. k1IA lbs/Tons/vr
3. °'; r / lbs/Tonslvr 4. f / lbs/Tons/yr 5. X 1 A ! lbs/I'ons/vr
5.2 Anticipated end use of primary commodities)to be mined:
5.3 Anticipated end use of incidental eommoditie(s)to be mined: i*') s A