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STATE OF COLOR ADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY RECEIVE0 <br /> Department of Natural Resources CLERK G RECORDER <br /> 1313 Sherman St.,-Room 215 <br /> Denver,Colorado 80203 <br /> Phone:(303)866-3567 101b NOV g q 3: f i [DIVIISION of <br /> FAX:(303)832-8106 4 RECLAMATION <br /> MINING <br /> SAFETY <br /> CONSTRUCTION MATERIALS <br /> REGULAR(112)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM <br /> CHECK ONE: ✓. There is a File Number Already Assigned to this Operation <br /> Pen-nit# M - 1986 140 (Please reference the file number currentlyassi <br /> bugpe d to this operation) <br /> - New Application(Rule 1.4.5 <br /> Amendment Application(Rule 1.10) <br /> (✓ Conversion Application(Rule 1.11) <br /> Permit# M 1,986 1-40 _ (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) cop lete 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 11"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 /> L Applicant/operator or company name(name to be used on permit): Park County <br /> 1.1 Type of organization(corporation,partnership,etc.): County Government <br /> 2. OPeration name(pit mine or site name): Merrill /Wright <br /> 3. Permitted acreage(new or existing site): 9.9 <br /> permitted acres <br /> 3.1 Change in acreage(+) 150.1 <br /> acres <br /> 3.2 Total acreage in Permit area 160.00 <br /> acres <br /> 4. Fees: <br /> 4.1 New Application <br /> 4.2 New Quarry Application $2,696.00 application fee <br /> 4.4 Amendment Fee _$3,342.00 quarry application <br /> 4.5 Conversion to 112 operation(set by statute) $2.229.00 amendment fee <br /> $2,696.00 conversion fee <br /> 5. Primary commodities)to be mined: Road Base Chip rock Sand <br /> 5.1 Incidental commoditie(s)to be mined: 1. - lbs/Tons/yr 2. <br /> - — / lbs/Tons <br /> 3• / lbs/Tons/vr 4. / lbs/Tons/vr <br /> 5• / lbs/Tons/vr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: Road Maintenance/ Reconstruction material <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: <br />