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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural Resource RECEIVED <br /> 1313 Sherman St., Room 215 ERR WHE <br /> Denver,Colorado 80203 M-2009-074 CN01 AUG 01 2017 COL S R A D O <br /> D I V I S I O N O F <br /> Phone (303)866-3567 Annual Fee/Re RECLAMATION <br /> FAX (303)832-8106 port: C+W MINING <br /> Violations: DIVISION OF RECLAMATION _&— <br /> MV-2017-009 MINING AND SAFETY 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 /> Permit# M - - (Please reference the file number currently assigned to this operation) <br /> New Application(Rule 1.4.5) Amendment Application(Rule 1.10) <br /> Conversion Application(Rule 1.11) <br /> Permit# M -2009- 074 - (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) 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 1 1" 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 /> I Applicant/operator or company name(name to be used on permit): Colorado Backhoe Service <br /> 1.1 Type of organization(corporation,partnership,etc.): private company <br /> 2. Operation name(pit,mine or site name): The Orr Pit <br /> 3. Permitted acreage(new or existing site): 9.99 permitted acres <br /> 3.1 Change in acreage(-+-) 15.13 acres <br /> 3.2 Total acreage in Permit area 25.12 acres <br /> 4. Fees: <br /> 4.1 New Application �5,309..M application fee <br /> 4.2 New Quarry Application 310�X� quarry application <br /> 4.4 Amendment Fee $0POW 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: Gravel Sand Borrow <br /> 5.1 Incidental commoditie(s)to be mined: 1. - lbs/TonsX/ 2. / lbs/Tons/yr <br /> 3 lbs/Tons/yr 4. / lbs/Tons/yr 5. / lbs/Tons/yr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: Specification aggregates, fill material <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: <br />