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STATE of COLORA O <br /> DIVISION OF RECLAMAnoN,MINING AND SAFETY <br /> Department of Natural Resources copy <br /> 1313 Sherman St.,Room 215 �C_y,�" <br /> Denver,Colorado$0203 n OO 1 Q1 0 %Boo <br /> Phone;(303)866-3567 2�� CUt5'TRHCT'10NIA'1'F,RIALS RECLAMATION <br /> FAX:i3031B328t06 13 k ) a �, MINING <br /> KOc �� REGULAR(!12)OPERATION SAFETY <br /> LTY <br /> N LAMATION PERMIT APPLICATION FORM <br /> sill ititter,)r, <br /> Governor <br /> CHECK ONE: "There is a File Number Already Assigned to this Operation Harris 0-Sherman <br /> Executive Director <br /> Permit K 'M (Please reference the file number currently assigned to this operatij&is w.Catwn.• <br /> X New:application(Rule 1.4.5) Amendment Application(Rule 1.10) Division Director <br /> Natural Resource Trustee <br /> Conversion Application(Rule 1,11) <br /> Permit# ill - -_ (provide for Amendments and Conversions of existing permits) <br /> The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major 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 of 6.5(Geotecbnicat Stability Exhibit,and acheck for <br /> the application fee described under Section(4)below. Exhibits should NOT be bound or in a 3-ring binder;maps should be folded to <br /> 8 1;2"X 11"or 8 [Z'X 14"size. To expedite processing,please provide the information in the format and order described in this form. <br /> GENERAI,OPERATION NFORMATION <br /> Type or print clearly,in the space provided,A L .information requested below. <br /> I. Applicant/ot7erator or company name(name to be used on permit): Western Gravel, LLC <br /> 1.1 Type of organization(corporation,partnership,etc,): Corporation <br /> 2. Operation name(pit.mine or site namel: WRC Gravel Pit <br /> 3. Permitted acreage(new or existing site): 1 9 1 -8 3 permitted acres <br /> 3.1 Change in acreage(I-) acres <br /> 3.2 Total acreage in Permit area 191 .83 _ acres <br /> 4. Fees: <br /> 4.1 New Application $2.696.00 application fee <br /> 4.2 New Onarry Application $3..342.00 quarry application <br /> 4.4 Amendment Fee $2,229.00 ametxirnent fee <br /> 4.5 Conversion to 112 open Lion(set by statute) $2,6%.00 conversion fee <br /> 5. Printary commodities)to be mined: Gravel <br /> 5.1 incidental comrrediiic(sl ro be niinecf: 12 50 11:b-r i'on-,,V 2, ! 'ronsivr <br /> 3.T lbsr r nn `y.I 4.. _ W' ____...�> 1�1»YL 5. _: IL-b* &n1i_ <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: _Road Base_ <br /> 5.3 Anticipated end use of incidental cotrrmoditic(s)to be mined: <br /> i <br /> t <br /> i <br /> office of Office of <br /> Mined I.and Reclamation I4enver Grand Junction Durango Xctive,and tndctive Mutes <br />