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STATE OF COLORADO <br />IDIViSION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources (jN;0 <br />1313 Sherman St., Room 215 Denver, Colorado 80203 COLORADOPhone: (303) 866.3567 d) p r v r s r a rr o r <br />RbCLAMATION <br />FAX; (303)632 6106 f 1 Violation: MINING <br />MV -2016-052 ��+ SAFETY <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATIONMAR r 3 zoo <br />RECLAMATION PERMIT APPLICATION FORA[O ks/ON 0. <br />1 <br />CHECK ONE: I^ -I ._ There Is it Pile Number Already Assigned to this Operation &V- TION <br />Pe 't # M - 2000- 018 (Please reference the file number currently assigned to this operation) <br />RNew Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />-- Conversion Application (Rule 1.11) <br />Pennit # M -2000z018 (provide for Amendments and Conversions of existing permits) <br />The application for a Constniction Materials Regular 112 Operation Reclamation Pcnnit contains three major parts: (1) the application <br />form; (2) Exhibits A -S, Addendum 1, any sections of Exlubit 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 of6.5 (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 l/2" X 11" or 8 112" X I4" 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. Applicauttoperator or company name (name to be used on nermit): <br />Cheyenne County <br />1.1 Type of organization (corporation, partnership, etc.): Countv <br />Government <br />2. Operation name (nit, mine or site name): Munsch Pit <br />3. Permitted acreage (naw or existing site): <br />9•$ <br />permitted acres <br />3.1 Change in acreage (+) <br />10,49 <br />acres <br />3.2 Total acreage in Permit area <br />19.99 <br />acnes <br />4. Femme. : <br />4.1 New Application <br />$2,696,00 <br />application fec <br />4.2 New Quarry Application <br />_$3,342.00 <br />quarry application <br />4A Amendment Fee <br />$2,229.00 <br />amendment fee <br />4.5 Conversion to 112 operation (bet by statute) <br />$2.696.00 <br />conversion fee <br />5. Primary commoditlefsl to be mined: Sand Gravel <br />5.1 . _ &/Tons/vr 2. lbs/Tonsl <br />3.— / lbs/Cons& 4. _ / lbs/Ibnslxa 5. 1 lbsiTots/vr <br />5.2 Anticipated cnd use of primary commodilie(s) to be mined:_ Sand & gravel to be spread on county roads <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: - NA <br />