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DIVISION OF RECL <br />DsPwWranl or Nalural I <br />1313 Sherman St„ Roo <br />Derwer, Colorado 00203 <br />Phone: (303) BB&M? <br />FAX (303) 832.8108 <br />TC1 WHE <br />M-1978-051 CN01 <br />V Annual Fee/Report: CW <br />if No Violations <br />,ATE OF COLORADO <br />RECEIVED <br />OCT 10 2017 <br />DMSIOK OF RECLAii MON <br />10111MAND SAMY <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />COLORADO <br />a�r�siarr or <br />RECLAMATION <br />MINTING <br />SAFETY <br />CHECK ONE: Q_ There is a File Number Already Assigned to this Operation <br />P; <br /># X19 I8 051 (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 # M978 Q51 (provide for Amendments and Conversions of existing permits) <br />The application for it Construction Materials Regular 112 Operation Reclamation Permit contains three m*r parts: (1) the application <br />form; (2) Exhibits A -S, Addendum 1, any sections orExhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to Include one (1) com2leta sign2d Ed notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies ofExhibits 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 Wader,, maps should be folded to <br />B 112" X t l" or 8 112" X 14" size. To expedite processin& please provide the information in the format and order described In this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, is the space provided, Aja information requested below. <br />1. r n s Ur=InCounty <br />1.1 Type of organization (corporation. partnership, etc.): Government <br />2. Operation name (pit Mi ft or site ramal: Gaeft PR <br />3. Permitted aerme (new or existins? sltel: 9.9 permitted acres <br />3.1 Change in acreage (+) 30 serer <br />3.2 Total acreage in Permit area 39.9 acres <br />4. Fees: <br />4.1 New Application S2,621.00 application fee <br />4.2 Now Quarry Application $3.342.00 quarry application <br />4.4 Amendment Fee _S2.22M amendment fee <br />4.5 Conversion to 112 operation (set by statute) SU96.00 conversion fee <br />5. Prfaury eemmodltie(sl to be mined: Sand Grml <br />5.1 Incidental cormmodide(s) to be mined: 1, jb5aalir 2. / Ibsrlons/vr <br />3. / -lbs/Tons/yr 4. 1 lbs/Tonstyt 5. _ _ _ / ffislt onslvr <br />5.2 Anticipated end use of primary cammoditie(s) to be mined: December, 2042 <br />53 Anticipated and use orincidental eormmoditie(s) to be mined: <br />