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DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 235 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />@(Dul pl�. <br />M-2018-415 <br />jw gfrn <br />STATE OF COLOfQ <br />14t RECEIVED <br />CON5tKULJIVll riu•asJ..,...... <br />SPECIAL, (I 11) OPERATION <br />APR-.' .;.%zat g <br />5or <br />aV1 MOF REC �'ATioN <br />! l:I AMD I -TY <br />RECLAMATION PERMIT APPLICATION FORM <br />The application for a Construction Materials Special 1 I I Operation Reclamation Permit contains four major parts: (1) the application form; <br />(2) Exhibits A -L, Addendum 1, and any sections of Exhibit 6.5 (Geotechnical Stability Exhibit), as required by the Office, and outlined in <br />Rulcs 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); (3) the application fee; (4) the Perfomnance Warranty and ifrequired a Financial Warranty. When <br />you submit your application, be sure to include one (I ) completed, signed and notarized ORIGINAL and one (1) copy of the completed <br />application fors, two (2) copies of Exhibits A -L, Addendum 1, appropriate sections of Exhibit 6,5 (Geotechnical Stability Exhibit), as <br />required, a check for the application fee described under (4) below, and the fully executed Performance Warranty and Financial Warranty, if <br />required. Exhibits should NOT be bound or in 3 -ring binders; maps should be folded to 8 2" X 1 I" or 8 2" X 14" size. To expedite <br />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 described below <br />I, Applicant/operator or company name (name to be used on the permit): <br />Fremont Paving and Redi Mix Inc <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />2. Operation name (pit -mine -or site name): Mask Ranch Pd #2 <br />3. Permitted acreaee: 18 acres permitted Acres <br />4. New Application: �58�� Application Fee <br />5. PHmary commod itie(s) to be mined: Gravel and Aggregate 5 <br />6. Name or owner to the surface of affected land: <br />Mask LLC <br />7. Name of owner to the subsurface rights of affected land: Mask LLC <br />8. Type of minim' operation: ED Surface a Underground <br />0 In-situ <br />9. Location information: The center of the area where the majority of mining will occur <br />COL Archuleta <br />PRINCIPAL MERIDIAN (check one): `� 6th (Colorado) 10th (New Mexico) L. Ute <br />SECTION (write number): S 25 <br />TOWNSHIP (write number and check direction): T 35 North South <br />RANGE (write number and check direction): R 2 East ✓ West <br />QUARTER SECTION (check one): ✓ NE NW SESW <br />QUARTER/QUARTER SECTION (check one): NE NW SE kSW <br />GENERAL DESCRIPTION: (the number of miles an irection from the nearest town and the approximate elevation)The propedy i -.g 10GAted approximately O.R.1 mileS south of Pago-,a Springs, Coinmrin <br />- <br />Office of Office of <br />Mined Land Reclamation Denver • Grand lunction • Durango Active and Inactive Mines <br />