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0 <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY - "-- <br />Oep arnent of Natutal Rmiurcr, <br />A <br />1313 Sherman 5? . (dorm 21 S RECEIVED <br />Denver, Color.uk) 111120 t <br />Phone: 1303► 86h- nro <br />FAX- (303) 81:-811(1 <br />DEPARTMEW OF <br />CONSTRUCTIONMATERIALS NATURAL <br />REGULAR OPEaATION (11JIrisien 6i innet>als a deeledii` RESOURCES <br />Ronwr <br />RECLAMATION PERMIT APPLICATION FOPJ4 aGovemorve�nor <br />limes S. Lochhead <br />EarCutive Dueclor <br />hiicharl B Long <br />Division D.rectrn <br />CHECK ONE: New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit f M -_85 - 031 (provide for Amendments and Conversions of <br />existing permits) <br />The application for a Regular 112 Operation Reclamation Permit contains three major parte: (1) <br />the application form= (2) Exhibits A -S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical <br />Stability Exhibit; and (3) the application fee. When you submit your application, be sure to <br />include one (1) complete signed and notarized IVORY ORIGINAL and four (4) copies of the completed <br />ivory application form, five (5) copies of Exhibits A -S, Addendum 1, appropriate sections of 6.5 <br />(Geotechnical Stability Exhibit, and a check for the application fee described under Section (4) <br />below. Exhibits should not be bound or in a 3 -ring binder; maps should be folded to 8 1/2" X 11" <br />or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and <br />order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly in the space provided the information requested below. <br />G==CZ====aaaa=��= aaaaan=aaa==pea= z�=p====caaaaa=CC===C==cnanaaaaCca====a as a aa===ate--xaa.=�aa. <br />1. Applicant/operator or company name (name to be used on permit): <br />Montezuma County <br />1.1 Type of organization (corporation, partnership, etc.) : _ County, Goyprnment _ <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: B4-6000786 <br />2. Operation name (pit, mine or site name): Mancos Gravel Pit <br />3. Permitted acreage (new or existing site) 9.9 _ permitted acres <br />3.1 Change in acreage (+ or -) +40.0 acres <br />3.2 Total acreage in Permit area 50.0 acres <br />4. Fees: <br />4.1 New Application _ S1,875.00 application fee <br />4.2 New Quarry Application X2.325.00 quarry application <br />4.3 Milling Application (Non-DHO) 53,100.00 milling application <br />4.4 Amendment Fee 51.550.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) * _g1 875.00 conversion fee <br />5. Primary_ co oditie(st to be mined: sand _, gavel <br />5.1 Incidental commodities) to be mined: 1. lbs/Tans/yr <br />2. _ / lbs/Tons/yr 3. / lb5lTons/vr <br />4. _ / lbs/Tana/yr S. lbs/Tons/yr <br />5.2 Anticipated end use of primary commodities) to be mined: road congtrUpti!Dn <br />5.3 Anticipated end use of incidental commodities) to be mined: <br />