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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 <br /> Denver,Colorado 80203 C O L O R A D O <br /> Phone:(303)866-3567 DIVISION o r <br /> RECLAMATION <br /> FAX:(303)832-8106 <br /> MINING <br /> --&SAFETY <br /> CONSTRUCTION MATERIALS <br /> REGULAR(112)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM <br /> CHECK ONE:❑_ There is a File Number Already Assigned to this Operation <br /> Permit# M - - -_ (Please reference the file number currently assigned to this operation) <br /> 0—New Application(Rule 1.4.5) D-Amendment Application(Rule 1.10) <br /> D—Conversion Application(Rule 1.11) <br /> Permit# M - - - (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 of6.5(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 <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. <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): J-2 Contracting Company <br /> 1.1 Type of organization(corporation,partnership,etc.): Corporation <br /> 2. Operation name(pit,mine or site name): DPG Pit <br /> 3. Permitted acreage(new or exiistin¢site): 227.52 permitted acres <br /> 3.1 Change in acreage(+) 227.52 acres <br /> 3.2 Total acreage in Permit area 227.52 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: Sand Gravel <br /> 5.1 Incidental commoditie(s)to be mined: 1. - lbs/Tons/vr 2. / Ibs/Tons/vr <br /> 3. / lbs/Tons/vr 4. / lbs/Tons/yr 5. / lbs/Tons/vr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: Construction Aggregates <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: N/A <br />