2018-09-08_REVISION - M2018016

• Permit No: M2018016
• IBM Index Class Name: Revision
• Doc Date: 9/8/2018
• Doc Name: Request For Amendment To Permit
• From: Empire Aggregates
• To: DRMS
• Type & Sequence: AM1
• Email Name: PSH
• Email Name: MAC
• Media Type: D
• Archive: No

STATE C )U
DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources eoI6 AM 0 1
1313 Sherman St.,Room 215 .
Denver,Colorado 80203 w ;N of
Phone:[phone] RECLAMATION
FAX:[phone] I V E D MINING
SEP 18 2018 SAFETY
00
CONSTRUCTION MATERIALS DIVISION OF RECLAMATION p• S N
REGULAR(112)OPERATION MINING AND SAFETY -' a O
RECLAMATION PERMIT APPLICATION FORM 3
O o �
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CHECK ONE:�_ There is a File Number Already Assigned to this Operation �•
Permit# M - - (Please reference the file number currently assigned to this operation) p� <, 0)
c, o
0—New Application(Rule 1.4.5) Amendment Application(Rule 1.10) O m
Conversion Application(Rule 1.11) Cn N
Permit# M - - - (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1)the applicatio =
form;(2)Exhibits A-S,Addendum 1,any sections of Exhibit 6.5(Geotechnical Stability Exhibit;and(3)the application fee. When yot
submit your application, be sure to include one (1) compete signed and notarized ORIGINAL and one (1) copy of the completed 3
application form,two(2)copies of Exhibits A-S,Addendum 1,appropriate sections of 6.5(Geotechnical Stability Exhibit,and a check for n
the application fee described under Section(4)below. Exhibits should NOT be bound or in a 3-ring binder;maps should be folded to
8 1/2"X 11"or 8 1/2"X 14"size. To expedite processing,please provide the information in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or print clearly,in the space provided,ALL information requested below.
1. Applicant/operator or company name(name to be used on permit): Empire Aggregate, Inc.
1.1 Type of organization(corporation,partnership,etc.): Limited Liability Corporation
2. Operation name(pit,mine or site name): Douglas Mountain Mine
3. Permitted acreage(new or existing site): 68.1 permitted acres
3.1 Change in acreage(+) acres
3.2 Total acreage in Permit area acres
4. Fees:
4.1 New Application $2,696.00 application fee
4.2 New Quarry Application $3,342.00 quarry application
4.4 Amendment Fee $2,229.00 amendment fee
4.5 Conversion to 112 operation(set by statute) $2,696,00 conversion fee
5. Primary commoditie(s)to be mined: sand gravel
5.1 Incidental commoditie(s)to be mined: 1. - lbs/Tons/vr 2. / lbs/Tons/yr
3. / lbs/Tons/vr 4. / Ibs/Tons/yr 5. / lbs/Tons/vr
5.2 Anticipated end use of primary commoditie(s)to be mined: Construction materials
5.3 Anticipated end use of incidental commoditie(s)to be mined: