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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND c <br /> Department of Natural Resources RECEIVED <br /> 1313 Sherman St.,Ror- <br /> Denver,Colorado 8020, C O L O R A D O <br /> Phone:(303)666 3567 pp 0 9 2Q19 D IV I SION OF <br /> FAX:(303)832-8106 �Q/'(/�/ MINING <br /> L 1V <br /> Slmac 'ik <br /> " SIGN Ol REGC`tAMA710Niso —&— <br /> E� MINING AND SAFETY SAFETY <br /> CONSTRUCTION MATERIALS <br /> REGULAR(112)OPERATION N 0 3 <br /> RECLAMATION PERMIT APPLICATION FORM o a G <br /> � a � <br /> •- N <br /> CHECK ONE:�_ There is a File Number Already Assigned to this Operation a b <br /> Permit# M 20' 004 - O <br /> _ (Please reference the file number currently assigned to this operation) N 06 <br /> New Application(Rule 1.4.5) Amendment Application(Rule 1.10) <br /> Conversion Application(Rule 1.11) <br /> Permit# M 2012 0-04 - (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)Exhibits 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 signed and notarized ORIGINAL 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 NOT be bound or in a 3-ring binder:maps should be folded to m D <br /> 8 1/2"X I I"or 8 1/2"X 14"size. To expedite processing,please provide the information in the format and order described in this form. N <br /> O <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly,in the space provided,AI.L information requested below. <br /> 1. Apabcant/ooerator or company name(name to be used on permit): Superior Oilfield Services CO., Ltd. <br /> 1.1 Type of organization(corporation,partnership,etc.): LLC <br /> 2. Oneration name(pit mine or site name): North Star Pit <br /> 3. Permitted acreage(new or eustine site): 12.55 permitted acres <br /> 3.1 Change in acreage(+) 14.61 acres <br /> 3.2 Total acreage in Permit area 27.16 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 fec <br /> 5. Primary commoditie(s)to be mined Sand Gravel <br /> 5.1 Incidental commoditie(s)to be mined: 1. Ibs"Tons/yr 2. i lbs,"Tons/yr <br /> 3. ,' lbs/Tons/vr 4. / lbs/Tons/yr 5. / lbsiTons/yr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: Roads & Drilling Pad Site Construction <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: <br />