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STATE OF COLOZADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 <br /> Denver,Colorado 80203 C O L O R A D O <br /> DIVISION <br /> CONSTRUCTION MATERIALS O r <br /> Phone:(303)86b 3567 RECLAMATION <br /> FAX:(303)832-8106 REGULAR(112)OPERATION MINING <br /> RECLAMATION PERMIT APPLICATION FORM SAFETY <br /> Bill Ritter,Jr. <br /> CHECK ONE: Z✓ There is a File Number Already Assigned to this Operation Governor <br /> 1980 Harris D.Sherman <br /> P M -_- 2 (Please reference the file number currently assigned to this operatiox)ecutive Director <br /> New Application(Rule 1.4.5) Amendment Application(Rule 1.10) Ronald W.Cathny <br /> Division Director <br /> El Conversion Application(Rule 1.11) Natural Resource Trustee <br /> Permit# M - _ 1980- 112 (provide for Amendments and Conversions of existing pewits) <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(Geotechnical Stability Exhibit,and a check 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 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. <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly,in the space provided,ALL information requested below. <br /> 1. Ayylicant/onerator or company name(name to be used on permit): Rio Blanco County Road and Bridge <br /> 1.1 Type of organization(corporation,partnership,etc.): Government <br /> 2. Operation name(pit,mine or site name): Bachmann Gravel Pit <br /> 3. Permitted acreage(new or esistine site): 25.64 permitted acres <br /> 3.1 Change in acreage(+) 48.13 acres <br /> 3.2 Total acreage in Permit area 73.77 acres <br /> 4. Fees: <br /> 4.1 New Application $2,696.00 application fee <br /> 4.2 New Quarry Application $3,342.00 quarry application <br /> 4.4 Amendment Fee $2,229.00 amendment fee <br /> 4.5 Conversion to 112 operation(set by statute) $2,696.00 conversion fee <br /> 5. Primary commoditie(s)to be mined: rag yel sand <br /> 5.1 incidental commoditie(s)to be mined: 1. lbs/Tons/yr 2._ / Jbs/Tons/vr <br /> 3. / Ibs/TOns/vr 4. / lbs/Tons/vr 5. / Ibs/rons/yr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: Road Base <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined:ROad Base <br /> Office of Office of <br /> Mined land Reclamation Denver • Grand Junction • Durango Active and inactive Mines <br />