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STATE OF COLORADO <br /> Cg'1f1SM tW WLUAT1C .MINIM A40 E1a4FEW <br /> ba�Iart frrlr of Nat n*Rehwt C" <br /> 1313 Shermin St.,Room 21S <br /> t3WWW,COW WO W243 C O L O K A D t3 <br /> Phone4(303)SWW7 DIVISION o f <br /> RECLAMATION <br /> lax ( I3)e x-$tos MINING <br /> SAATY <br /> i <br /> CONSTRUCTION 141ATFRIAL S <br /> REGULAR(112)OffAtATION <br /> RECLAMATION PERMIT APPLICATION FORM <br /> C13EC1�QNE; _ There is a FRt Number Already Assigned to this Operation <br /> P t tt—MRI a .,.,,.. (Please reference tit fik number currently <br /> assigned to this operation) <br /> New Application(Rule 1,43) Amendment Application(Rule 1,10) <br /> Conversion Application(Rule I.11) <br /> Permit# _ -� . - (provide fur Amendments and Conversions of existing permits) <br /> IU application ibr a Construction Materials Regular 112 Operation Reclamation Permit contains titter mayor its;(1)the application <br /> foal;(2)Exhibits A-S,Addendum 1,any sections of Exhibit 63(Geotechnical Stability Eximibit;and(3)the application fit. W)"you <br /> submit your application, be sure to Include one(1) sistrd AW notanzd ORIGINAL and one(1)copy of the completed <br /> application form,two(2)cuts of Exhildts A-S,Addendum 1,appropriate sections of 6.5(Goo ttthnical Stability Exhibit,and a check for <br /> the application fee dam bed under Section(4)below. Exhibits should D:be bound or In a 3-ring binder.rheas should be folded to <br /> 3 112"X l I"or 9 1/2"X 14"size. To expedite processing,please provide the information in the fs~and order described in this form. <br /> GENERAL OPERATION INFORMATION <br /> Type or print curly.in the space provided Information requested below. <br /> I. Agwinaltoperstor p£22mmex nam tome to lie homed ors ): Southway Cnngt uctim C;w» ,1nc.of AWams <br /> I,I Type of organization(wrpontion,partne hip,atc.); n <br /> 2. Querallan nagl(AJ die or vite,name Br"Ord MOSS CIUSfY <br /> 3• egaW lW g&regite(now or existin te): 1190.2 permitted acres <br /> 3.1 Change in acreige N/A g <br /> 3.2 Total acreage in Permit atrea 19Q 2 ass <br /> 4, <br /> 4.1 New Application S2,42fi.0 application fee <br /> 4.2 New Quarry Application $1342M,,, quarry application <br /> 4.4 Amendment lyre S2,229,00 amendment fee <br /> 4.5 Conversion to 112 operation(set by statute) S2.6%.00 eversion fw 1 <br /> 1 <br /> 5. C'1�CY e+ammoditlets)to bi mom: b8t58 gravel <br /> SA Incidental contowdirit(s)lo be mined: 1. WA� lbstl'onstvr 2. N/A 1_bstCorthltvr <br /> 3. NIA I twaawa 4. NIA a lbstlbnslvr S. IWA i hu>slvr <br /> 52 Anticipated card use of primary eomtmoditie(s)to be muted; constructim rmteftl <br /> 1 <br /> 5.3 Anticipated hand use of incidental commoditfe(s)to be mined: N/A <br />