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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 <br /> Denver,Colorado 80203 C O L O R A D O <br /> Phone:(303)866-3567 DIVISION O F <br /> FAX:(303)832-8106 RECLAMATION <br /> MINING <br /> &— <br /> SAFETY <br /> CONSTRUCTION JLAITMA LS <br /> REGULAR(112)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM <br /> CHECK OXE:Q_ The,-e Is It File Number Already Assigned to this Operation <br /> Permit» M2m?- 056 (Please reference the file munber currently assigned to this operation) <br /> New Application(Rule 1.4.5) 0-Amendment Application(Rule I.10) <br /> COUVersion application(Rule 1.11) <br /> Permit# M - 2001 Q56 (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)Exlnbits 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 simmed and notarized ORIGLIAL 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\OI be bound or in a 3-ring binder:maps should be folded to <br /> 8 U2"`Y I I"or 8 1/2"Y 14"size. To expedite processing.please provide the inforw Lion in the format and order described in this form. <br /> GENERAL OPERATION INFOR-NUTION <br /> Type or print clearh•,in the space proOded, I information requested below. <br /> 1. ApplicatiVoperstor or company name(name to be used on permit): Elbert County,County Government <br /> 1.1 Type of organization(corporation,partnership.etc.): Goverment <br /> 2. Operation name(pit,mine or site name): Belveal Pit <br /> 3. Permitted acreage(men'or existing site): 9.9 permitted acres <br /> 3.1 Change in acreage(—) +157.6 acres <br /> 3.2 Total acreage in Permit area 167.5 acres <br /> 4. Fees: <br /> 4.1 New Application $2.696.00 application fee <br /> 4.2 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) 1 $2.696.00 conversion fee <br /> S. Primary commoditie(s)to be mined: Sand Gravel Base <br /> 5.1 Incidental commoditie(s)to be mined: 1. NA ibs;T9Hi)g 2 / lbs,Tons,',,T <br /> 3. ibs'Toas,-* 4. lbsTons,vr 5. lbs,Tons,tr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: County Projects Construction/Maintenance <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined.. NA <br /> 7 <br />