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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural Resources RECEIVED <br /> 1313 Sherman St.,Room 215 C O L O R A D O <br /> Denver,Colorado 80203A � � ? a D t V 1 s . o N o r <br /> Phone:(303) 2-810 67 RECLAMATION <br /> M02FAX:(303)832-8106 J/nM, 6L 1 DMS"OF RECLAMATION MINING <br /> J !YIUP JPL� MN'NGMDWETY SAFETY <br /> CONSTRUCTION MATERIALS <br /> LIMITED IMPACT(110)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM ; <br /> 3 <br /> ov N <br /> d$9 <br /> CHECK ONE: There is a File Number Already Assigned to this Operation a <br /> s �to 082 eQ N <br /> Permit# l� _ (Please reference the file number currently assigned to this operation) <br /> New Application(Rule 1.4.5) Amendment Application(Rule 1.10) <br /> Conversion Application(Rule l 11) <br /> Permit# M _ 2010_ 082 - $8�(provide for Amendments and Conversions of existing permits) <br /> The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1)the <br /> application form;(2)Exhibits A-J,Exhibit L,Addendum 1,any sections of Exhibit 6.5 and Geotechnical Stability Exhibit,as required by <br /> the Office,and outlined in Rules 6.1,6.2,6.3,6.5,and 1.6.2(1)(b);and(3)the application fee. When you submit your application,be sure <br /> to include one (1)complete signed and notarized ORIGINAL and one (1) copy of the completed application form,two(2)copies of <br /> Exhibits A-J,Exhibit L, Addendum 1,and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required,and a check for the <br /> application fee described under(4)below. Exhibits should NOT be bound or in a 3-ring binder;maps should be folded to 8 1/2"X I I"or 8 0 <br /> 1/2"X 14" size. To expedite processing,please provide the information in the format and order described in this form. <br /> aI <br /> -N <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly,in the space provided, ALL information described below. <br /> 1. Ayolicant/overator or company name(name to be used on permit): Lincoln County <br /> 1.1 Type of organization(corporation,partnership,etc.): County Government <br /> 2. Operation name(pit,mine or site name): Jamaco Pit <br /> 3. Permitted acreaze(new or existine site): 6.07 permitted acres <br /> 3.1 Change in acreage(+) 3.73 acres <br /> 3.2 Total Acreage in Permit Area 9.8 acres <br /> 4. Fees: <br /> 4.1 New Application: $1258.00 application fee <br /> Amendment Fee(C.R.S.34-32.5-125(11)): $827.00 application fee <br /> 5. Primary commoditie(s)to be mined: Sand Gravel <br /> 5.1 Incidental commoditie(s)to be mined: 1. / Ibs/Tons/yr 2. / lbs/Tons/yr 3. / lbs/Tons/yr <br /> 4. / lbs/Tons/yr 5. / lbs/Tons/vr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: County Road Maintenance <br /> Anticipated end use of incidental commoditie(s)to be mined: <br />