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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1393 Sherman St., Room 215 <br />Denver, Colorado 80203 COLORADO tv sr <br />Phone@@Ipir (303) 866-3567 �*' RECLAMATION <br />FAX: (303) 832-8106 0 MINING <br />NOV 0 SAFETY <br />CONSTRUCTION MAT1WOF "CLAMAT'" <br />REGULAR (112) OPERAT56 AND BABY <br />AA <br />✓COMPLIED! <br />✓0 Violations <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: Qx __ There is a File Number Already Assigned to this Operation <br />Permit # M �� 83 -_11a9 (Please reference the file number currently assigned I MAC, WHE <br />ELNew Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />!— Conversion Application (Rule LI l ) <br />Permit # M - 19 - 83 -139 (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 I, 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) com2lete si e a d 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 11" or 8 112" 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 />1. Applicant/operator or company name (name to be used on permit): Pioneer Sand Company, Inc. <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />2. Operation name (pit, mine or site name): Leyden Pit <br />3. Permitted acreage new or existin site): 318 permitted acres <br />3.1 Change in acreage (+) acres <br />3.2 Total acreage in Permit area 318 acres <br />4. Fees: <br />4.1 <br />New Application <br />$2,696.00 <br />application fee <br />4.2 <br />New Quarry Application <br />$3-342.00 <br />quarry application <br />4.4 <br />Amendment Fee <br />$2.229.00 <br />amendment fee <br />4.5 <br />Conversion to 112 operation (set by statute) <br />$2,696.00 <br />conversion fee <br />5. Primary commoditie(s) to be mined: NIA <br />5.1 <br />Incidental commoditie(s) to be mined: 1. N/A - lbs/Tons/yr <br />2. N/A / <br />lbs/Tons/vr <br />3, NIA / lbs/Tons/yr 4. N/A / _ lbs/Ton s/vr <br />5. NSA / <br />lbs/Tons/yr <br />5.2 <br />Anticipated end use of primary commoditie(s) to be mined: NIA <br />5.3 <br />Anticipated end use of incidental commoditie(s) to be mined: NIA <br />