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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY CFIVED <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 SEP 18 2018 C O L O R A D O <br /> Denver,Colorado 80203 <br /> Phone:(303)866-3567 �IVI$I a t v i s i o N o f <br /> FAX:(303)832-8106CN01 ON OF RECLA�MgT10N RE MINING <br /> ION <br /> MINING AND SAFETY —&— <br /> SAFETY T ; <br /> o cD <br /> CONSTRUCTION MATERIALS $ m <br /> REGULAR(112)OPERATION y �' <br /> RECLAMATION PERMIT APPLICATION FORM <br /> a O <br /> C14ECK ONE: ✓� There is a File Number Already Assigned to this Operation o —' <br /> Permit# Mz o07 Q03 (Please reference the file number currently assigned to this operation) Cr <br /> La Cr <br /> New Application(Rule 1.4.5) 13—Amendment Application(Rule 1.10) 8 N <br /> Conversion Application(Rule 1.11) <br /> 0 <br /> Permit# M - - (provide for Amendments and Conversions of existing permits) 3 <br /> The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) on <br /> form;(2)Exhibits A-S,Addendum 1,any sections of Exhibit 6.5(Geotechnical Stability Exhibit;and(3)the application )u <br /> submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of d IZ <br /> application form,two(2)copies of Exhibits A-S,Addendum],appropriate sections of6.5(Geotechnical Stability Exhibit, __. .Gpu�rror o <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 t 1"or 8 1/2"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): Yevoli Cobblestone Inc. <br /> 1.1 Type of organization(corporation, partnership,etc.): Corporation <br /> 2. Operation name(pit,mine or site name): Yevoli Cobblestone Pit <br /> 3. Permitted acreage(new or existine site): 9.98 permitted acres <br /> 3.1 Change in acreage(+) 73.52 acres <br /> 3.2 Total acreage in Permit area 83.5 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) $2,696.00 conversion fee <br /> 5. Primary commoditie(s)to be mined: <br /> sand gravel <br /> 5.1 Incidental commoditie(s)to be mined: 1. 10000 lbs/Tons/vr 2. / lbs/Tons/yr <br /> 3. / lbs/Tons/yr 4. / Ibs/Tons/vr 5. / Ibs/Tons/vr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: construction materials <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: <br />