2016-10-31_PERMIT FILE - M2016074

• Permit No: M2016074
• IBM Index Class Name: PERMIT FILE
• Doc Date: 10/31/2016
• Doc Name: Application
• From: Layboum Pit
• To: DRMS
• Email Name: ERR
• Email Name: WHE
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY RECEIVED
Department of Natural Resources
1313 Sherman St.,Room 215 OCT p q C O L D RA D O
Denver,Colorado 80203 3 1 20 s
Phone:[phone] DIVISION o f
RECLAMATION
FAX:[phone] DIVISION OF RECLAMATION MINING
MINING&SAFETY 0) AFETY
CONSTRUCTION MATERIALS
LIMITED IMPACT(110)OPERATION
RECLAMATION PERMIT APPLICATION FORM
CHECK ONE: There is a File Number Alreadv Assigned to this Operation
Pe! M-2016.074 -rence the file number currently assigned to this operation)
✓ _ _...-I �Amendment Application(Rule 1.10)
Conversion Application(Rule 1.11)
Permit# M - - - (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Limited Impact(110)Operation Reclamation Permit contains three major parts: (1)the
application form;(2)Exhibits A-J,Exhibit L,Addendum 1,any sections of Exhibit 6.5 and Geotechnical Stability Exhibit,as required 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 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-J,Exhibit L,Addendum 1,and appropriate sections of 6.5(Geotechnicai Stability Exhibit),as required,and a check for the
application fee described under(4)below. Exhibits should NOT be bound or in a 3-ring binder;maps should be folded to 81/2"X I I"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
Type or print clearly,in the space provided, ALL information described below.
1. Applicant/overator or company name(name to be used on permit): Washington County Road and Bridge L-O
1.1 Type of organization(corporation,partnership,etc.): government
2. Operation name(pit,mine or site name): Laybourn Pit
3. Permitted acreage(new or eaistine site): 9.9 permitted acres
3.1 Change in acreage(+) acres
3.2 Total Acreage in Permit Area 9.9 acres
4. Fees:
4.1 New Application: $1258.00 application fee
Amendment Fee(C.R.S.34-32.5-125(II)): $827.00 application fee
5. Primary commoditie(s)to be mined: Gravel Clay Sand
5.1 Incidental commoditie(s)to be mined: 1. / lbs/Tons/vr 2. / lbs/Tons/vr 3. / lbs/Tons/vr
4. / lbs/Tons/vr 5. / lbs/Tons/vr
5.2 Anticipated end use of primary commoditie(s)to be mined: Gravel for road building
Anticipated end use of incidental commoditie(s)to be mined: