2017-02-15_PERMIT FILE - M2017004

• Permit No: M2017004
• IBM Index Class Name: PERMIT FILE
• Doc Date: 2/15/2017
• Doc Name: Application
• From: Oldcastle SW Group, dba Four Corners Materials
• To: DRMS
• Email Name: THM
• Email Name: GRM
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECWMTION,MINING AND SAFM
Department of Natural Resources
1313 Shemum St.,Room 215 C O L O RA D O
Dew,tolOrado 802t13 DIVISION OF
Phone:[phone] RECLAMATION
FAX:[phone] MINING
—�t—
SAFETY
CONSTRUCTION MATERULS
SPECIAL(111)OPERATION
RECLAMATION PERMIT APPLICATION FORM
The application fora Construction Materials Special I I I Operation Reclamation Permit contains four major parts:(1)the application form;
(2)Exhibits A-L,Addendum 1,and any sections of Exhibit 6.5(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); (3)the application fee;(4)the Performance Warranty and if required a Financial Warranty.When
you submit your application,be sure to include one(1)cosnoWed.sinned and notarized ORIGINAL and one(1)copy of the completed
application form,two(2)copies of Exhibits A-L,Addendum 1,appropriate sections of Exhibit 6.5(Geotechnical Stability Exhibit),as
required,a check for the application fee described under(4)below,and the filly executed Performs=Warranty and Financial Warranty,if
required. Exhibits should=be bound or in 3-ring binders;maps should be folded to 8 2"X I i"or 8 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. Applicsnt/operator or company name(name to be used on the DermiM,
Oldcastle SW Group,Inc.dba Four Comers Materials
1.1 Type of organization(corporation,partnership,etc.): Corporation
2. Operation name(pit mine or site name): South Fork#1 Pit
3. Permitted sicre e: 30 Permitted Access
4. New Application: 53"A0 Application Fee
5. Primary a mmodkie(al to be mined: Construction Sand and Gravel
6. Name of owner to the surface of affected laed• Colorado State Board of Land Commissioners
7. Name ofowner to the subanr[ace risltts of sdlected lard: Colorado State Board of Land Commissioners
8. Tvne of mhalim operation: II Surface a Underground II In-situ
9. Location information: The center of the area where the majority of mining will occur:
CO Rio Grande
PRINCIPAL MERIDIAN(check one): Ij 6th(Colorado) ✓ I Oth(New Mexico) 0 Ute
SECTION(write number): S 27
TOWNSHIP(write number and check direction): T 40 North South
RANGE(write number and check direction): R 4 jv(
East West
QUARTER SECTION(check one): Emobon
ENW SE SWQUARTERJQUARTER SECTION(check one): ENW SE SW
GENERAL DESCRIPTION:(the number of miles an from the nearest town and the approximate elevation):
approxi 5 n-lpq Fa-qt rif Routh Fork, CC) Flay. tg inn,
Office of Office of
Mined land Reclamation Denver • Grand)unction • Durango Active and Inactive Mines