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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,R.on 21.5 RECEIVED C O L O R A D O <br /> Denver,Colorado 80203 <br /> DIVISLON O F <br /> one:(303)866-3567 RECLAMATCON <br /> \ 303)832 8106 MINING <br /> OCT 2 2 2019 <br /> DIVISION OF RECL MA-n SAFETY <br /> CONSTRUCTION MfA v*pET. <br /> REGULAR(112)OPERATION <br /> "C.LAMATION MIT APPLICATION FORM <br /> CHECK ONE:�! There is a File Number Already Assigned to this Operation <br /> Permit 1t ti1 - - -jZ°) (Please reference the file number currently assigned to this operation) <br /> New Application(Rule 1.4.5) I Amendment Application(Rule 1.10) <br /> Conversion Application(Rule 1.11) <br /> Permit# M -L1-A_-12-9 (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 (I) complete signed and notari/ed 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 <br /> 8 1/2" X i l"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): ChYI , Y1 �0 1► u+ � Inn <br /> 1.1 Type of organization(corporation,partnership,etc.): C,m�� m <br /> 2. Operation name(pit,mine or site name): Eo�t rn..(�r�u <br /> 3. Permitted acreage(new or existine site): permitted acres <br /> 3.1 Change in acreage(+) _0 1 acres <br /> 3.2 Total acreage in Permit area 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 amendmeW fee <br /> 4.5 Conversion to 112 operation(set by statute) $2,696.00 conversion fee <br /> 5. Primary commoditie(s)to be mined: � _ �Yl0Al1YQ� <br /> 5.1 Incidental commoditie(s)to be minted: 111101 01 - lbs/Tons/yr 2. / Ibs/Tons/yr <br /> 3. / lbs/Tons/vr 4. / Ibs/rTons/vr 5. / ibs/Tons/yr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: SW a &LA[:e Ng VA rUZU1130 ynkk#4 0A <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: J1 IA <br />