2019-02-15_PERMIT FILE - M2018029

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RECEIVED Avlaw COLORADO o Division of Reclarnation, FEB 1 Z019 Mining and Safety ;:-,,.I nor.. : N<zurol DIVISION OF RECLAMATION 1313 Sherman Street,Room 215 ��14410 WIM Denver,Colorado 80203 I�wNN��uu�� V�V G� CONSTRUCTION MATERIALS SPECIAL OPERATION 111(1)(b) RECLAMATION PERMIT APPLICATION FORM The application for a Construction Materials Special I I I Operation Reclamation Permit contains four major parts: (1) the application form;(2)Exhibits A-L,Addendum 1,and any sections of Exhibit 6.5(Geotechnical Stability Exhibit),as required by the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); (3)the application fee; (4)the Performance Warranty and Financial Warranty. When you submit your application,be sure to include one completed,signed and notarized ORIGINAL and one copy of the completed application form, two copies of Exhibits A-L, Addendum 1, appropriate sections of Exhibit 6.5 (Geotechnical Stability Exhibit), as required, a check for the $400.00 application fee, and the fully executed Performance Warranty and Financial Warranty. Exhibits should NOT be bound or in 3-ring binders;maps should be folded to 8 ``/i'X i 1"or 8 '/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 described below 1. Applicant/operator or com an name name to be used on the permit): 0-1 14k to the I E ll3 4T ftoel �a hits C P i Ng c 1.1 Type of organization(corporation,partnership,etc.): \L L A G 2. Operation name(pit,mine or site name): © � r ��.!}+ 1 3. Permitted acreage: (must be 30 acres or less) 0 -y 1 Permitted Acres 4. Fees: 4.1 New Application $400.00 Application Fee 5. Primary commoditie(s)to be mined: 4)\ rC 6. Name of owner to the surface of affected land: 1'O se-p h �e 9t u��u Vh �JfO y f4 7. Name of owner to the subsurface rights of affected land: �'flseeln e�iV�R� Moo) l ►h- 8. Location information: The center of the area where the majority of mining will occur: COUNTY: Las Animas PRINCIPAL MERIDIAN(check one): F`l 6th(Colorado) n 10th(New Mexico) II Ute SECTION(write number): S 3— TOWNSHIP(write number and check direction): T 3 _F--1 North �_ South RANGE(write number and check direction): R (y East �_ West QUARTER SECTION(check one): _M NE F-1 NW FX L SE _F SW QUARTER/QUARTER SECTION(check one): F NE � NW F �_ SE =SW 1313 Sherman Street. Room 215, Denver, CO 80203 P 303.866.3567 F 303.832.8106 http://mining.state.cc.us ti"