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Q5� <br /> STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources RECEIVED M-2009-077 <br /> 1313 Sherman St.,Room 215 CN01 <br /> DenvPhone:(303)ado 80203 APB p 4 2017 Annual Fee/Report: CW <br /> Phone:(303)866-35G7 <br /> FAX:(303)832-8106 No Violations <br /> DIVISION OF RECLAMATION <br /> MINING AI MTION vIATERIALs <br /> REGULAR(112)OPERATION- <br /> RECLAMATION PERMIT APPLICATION FORM <br /> CHECK ONE:Q— There is a File Number Already Assigned to this Operation <br /> P ,t# M (Please reference the file number currently assigned to this operation) <br /> New Application(Rule 1.4.5) 13—Amendment Application(Rule 1.10) <br /> u/ Conversion Application(Rule 1.11) <br /> Permit# M - - - (piovide 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)complete signed and notarized ORIGINAL and one(1)copy of the completed <br /> application fo ni.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 l%2"Y 11"or 8 l''_"l 14"size To expedite processing,please provide tile information in the fornat and order described in tins form. <br /> GENER-AL OPERATION INFORMATION <br /> Type or print clearly,in the space provided,ALL information requested below. <br /> 1. Applicant/operator or comoanv name(name to be used on Hermit): Grimes Quality Floonng(dba Yucca Ridge Sand and Gravel) <br /> 1.1 Type of organization(corporation.partnership.etc.). Limited Liability Company <br /> 2 Operation name(pit,mine or site name): Dill Pit <br /> 3. Permitted acreage(new or existing site): 8.7 permitted acres <br /> 3.1 Change in acreage(+) +9,5 acres <br /> 32 Total acreage in Permit area 18.2 acres <br /> 4. Fees: <br /> 4.1 Neu Application $2,696.00 application fee <br /> 42 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)Y $2.696.00 conversion fee <br /> 5. Primary commodities)to be mined: Sand Gravel Base <br /> .5.1 incidental commodities)to be mined: I. NA - lbsiTonsLV 2 Ibs/Tons/yr <br /> 3. lbsrlouslyr 4. lbs/Tonstyr 5. lbs/Tous/yr <br /> 5.2 Anticipated end use of primary connmoditre(s)to be mined Construction <br /> 5.3 Anticipated end use of incidental com moditie(s)to be united: NA <br /> 7 <br />