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m o l l - .0 3 3 STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 <br /> Denver,Colorado 80203 C L S R A D <br /> DIVISION OF <br /> Phone:(303)866-3567 SEP 0 2 011 RECLAMATION <br /> FAX:(303)832-8106 M I N I N G <br /> SAFETY <br /> CONSTRUCTION MATERIALS Rill Ritter Jr. <br /> LIMITED IMPACT(110)OPERATION Governor <br /> Harris D.Sherman <br /> RECLAMATION PERMIT APPLICATION FORM Exeartive Director <br /> Ronald W.Camny <br /> Division Director <br /> CHECK ONE: There is a File Number Already Assigned to this Operation natural Resource Tnrstee <br /> Permit# M (Please reference the file number currently assigned to this operation) <br /> Noce Anr,lirati—(Q,,l.1 A 51 �_ _) AmnDdmnnt An..li�hi�n fl2,ylo 1 1!)1 <br /> Conversion Application(Rule 1.11) <br /> Permit# M - - - (provide for Amendments and Conversions of existing permits) <br /> The application for a Construction Materials Limited Impact(110)Operation Reclamation Permit contains three major parts: (1)the <br /> application form;(2)Exhibits A-J,Exhrbit L,Addendum 1,any sections of Exhibit 6.5 and Geotechnical Stability Exhibit,as required <br /> 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 <br /> sure to include one(1)conmlete signed and notarized ORIGINAL and one(1)copy of the completed application form,two(2)copies <br /> of Exhibits A-J,Exhibit L,Addendum 1,and appropriate sections of 6.5(Geotechnical Stability Exhibit),as required,and a check for <br /> the application fee described under(4)below. Exhibits should NOT be bound or in a 3-ring binder;maps should be folded to 8 1/2"X <br /> 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 /> GENERAL OPERATION INFORMATION <br /> Type or print clearly,in the space provided, ALL information described below. <br /> 1. Applicant/operator or company name(name to be used on permit): Harry Corkle Const <br /> L l Type of organization(corporation,partnership,etc.): Individual <br /> 2. Operation name(pit,mine or site name): Corkle Construction Pit #2 <br /> 3. Permitted acreage(new or existing site): 3.84 permitted acres <br /> 3.1 Change in acreage(+) acres <br /> 3.2 Total Acreage in Permit Area 3.84 acres <br /> 4. Fees: <br /> 4.1 New Application: $1,258.00 application fee <br /> Amendment Fee(C.R.S.34-32.5-125(H)): $827.00 application fee <br /> 4.2 Conversion Fee(from 110d to 110$2,696.00 conversion fee(Rule 1.11.2(2)) <br /> 5. Primary commoditie(s)to be mined: None Rec Only Permit <br /> 5.1 Incidental commoditic(s)to be mined: 1. 1 Ibs/Tons/vr 2. / lbs/Tons/vr 3. / lbs/Tons/yr <br /> 4._ / lbs/Tons/vr 5. / hbs/Tons/yr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: None Rec only permit <br /> Anticipated end use of incidental commoditie(s)to be mined:- None <br /> Office of Office of <br /> Mined Land Reclamation Denver • Grand function • Durango Active and Inactive Mines <br />