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fll tl1t11tfllifi fli <br /> sss (� <br /> STATE, OF COLORADO <br /> DIVISION OF MINERALS AND GEOLOGY <br /> Department of Natural Reiourcespar, ,15! <br /> 1313 Sherman St., Roam 215 ;r' <br /> Denver,Colorado 80203 <br /> Phone;(3U3)806-3567 <br /> FAX:(30 0 832-8106 ) .1 "1 <br /> v613p0 DEPARTMENT OF <br /> d1 Zr�o <br /> CONSTRUCTION MATP.RZALS C�L�M RESOURCES NATURAL <br /> REGULAR (112) OPERATIO�\�9 <br /> kov Romer <br /> RECLAMATION PERMIT APPLICATION FORM Governor <br /> lamt>S.lochhead <br /> A �y 00 <br /> 1 Execume D:rector <br /> ntiic hael 8.;a:g <br /> 0;.islor.ovec'.ur <br /> CHECK ONE: New Application (Rule 1.4.5) X Amendment Application (Rule 1.10) <br /> Conversion Application (Rule 1.11) <br /> Permit # M - 97 - 08 - (provide for Amendments and Conversions of existing <br /> permits) <br /> The application for a Construction Materials Regular 112 Operation Reclamation Permit contains <br /> three major parts: (1) the application form; (2) Exhibits A-S, Addendum 1, any sections of <br /> Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br /> application, be sure to include one (1) complete signed and notarized IVORY ORIGINAL and four (4) <br /> copies of the completed Ivgr application form, five (5) copies of Exhibits A-S, Addendum 1, <br /> appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application fee <br /> described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps <br /> should be folded to 8 112" X 11" or 8 1/2" X 14" size. To expedite processing, please provide <br /> 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 requested below. <br /> 1. AAplicant/operator or companv�'Ame_ (name to be u ed on permit) : <br /> Wostern Mobile Southernt"A subsidiary of Lafarge Corp. <br /> 1.1 Type of organization (corporation, partnership, etc. ) : Corporation <br /> 1.2 I.R.S. Tax --.D. No. or Social Security Number: <br /> 2. Operation name pit, mine or site name) : Hartman Pit <br /> 3. Permitted acreage (new or existing site) : 240 permitted acres <br /> 3.1 Change in acreage (=) acres <br /> 3.2 Total acreage in Permit area 240 acres <br /> 4 . Fees: <br /> 4 .I New Application $1,675.00 application fee <br /> 4 .2 New Quarry Application $2. 325.00 quarry application. <br /> 4.3 Milling Application (Non-DMO) $3, 100.00 milling application <br /> ** 4 .4 Amendment Fee $'_,550.00 amendment feel-- <br /> 4 .5 Conversion to 112 operation (set by statute) -c1, 875.00 conversion fee <br /> 5. Primary commodities) to be mined: Sand Gravel Structural Fill <br /> 5.1 Incidental commoditie(s) to be mined: 1. _ N/A lbs/Tons1vr <br /> 2. / lbs/T_ons/vr 3. / ibs/Tonslvr <br /> 4 . / lbs/Tons/vr 5. 1 lbs/Tons/vr <br /> 5.2 Anticipated end use of primary com_noditie(s) to be mired: Construction Materials <br /> 5.3 Anticipated end use of incidental commodities) to be mined: N/A <br />