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STATE OF COLORAP" <br /> DIVISION OF RECLAMATION,MINING AND SAFETY 410.14(io <br /> C7 <br /> Department of Natural Resources RECEIVED � C) ,I <br /> 1313 Stwman Si, 215• "0 3 <br /> Denver,Colorado 80203 C O L O 1 -0 co <br /> DEC o6niq [DIV IS r u, <br /> Phone:(303)866 3567 RECLAM (D <br /> FAX:(303)832-8106 MIN ill a �.i <br /> Dk MION OF RECLAMATION —S 0 V <br /> I ING&SAFETY SAF1 p' <br /> N <br /> CONSTRUCTION MATERIALS <br /> REGULAR(112)OPERATION <br /> ALFU.AMA'"U111 C Aii' CATOL11FORM <br /> CHECK ONE:�_ There is a File Number Already Assigned to this Operation p <br /> Permit# M - - -1Zq (Please reference the file number currently assigned to this operation) W o D <br /> New Application(Rule 1.4.5) �Amendment Application(Rule 1.10) W 3r <br /> Conversion Application(Rule LI1) 3 O O <br /> 0 cn W <br /> Permit# M (provide for Amendments and Converses 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 ORIGINAI, 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 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 /> GiEIW-)I�OPERATJON,iNFOlRMATION <br /> Type or print clearly,in the space provided,ALL information requested below,.},/ <br /> 1. Awlicant/operator or company name(name to be used on permit): <br /> 1.1 Type of organization(corporation,partnership,etc.): CMDDrat mi <br /> 2. Operation name(pit,mine or site name): Elbe et rou Yi t <br /> 3. Permitted acreage(new or existing site): permitted acres <br /> 3.1 Change in acreage(+) _ _ 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 12.229.()0 amendmeW free <br /> 4.5 Conversion to 112 operation(set by statute) $2.696.00 conversion fee <br /> 5. Primary commoditie(s)to be mined: Qtf� Qtw <br /> 5.1 Incidental commodities)to be mined: 01101 A - lbs/Tons/yr 2. / lbs/Tons/vr <br /> 3. / lbs/Tons/yr 4. / lbs//Tons/.yr 5. / Ibs/Tons/vr <br /> 5.2 Anticipated end use of primary commodities)to be mined: 1aYa .! * �YlA Yrbb�en alS <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: h IQ <br />