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DIVISION OF RECLAMATION, STATE F COLORADO— RECEIVED <br /> Department of Natural Resources M202000 <br /> 1313 Sherman St.,Room 215 ECS/mac Fie O 7 ZjE <br /> D RA D O <br /> Denver,Colorado 80203 <br /> Phone:(303)866-3567 CONSTRUCTION MATERIALS IVs [ ON o f <br /> MATIONFAX:(303)832-8106 REGULAR(112)OPERATION DIVISION OFREcNINGRECLAMATION PERMIT APPLICATION FORM MINWANDFETY <br /> Bill Ritter,Jr. <br /> CHECK ONE: ❑ There is a File Number Already Assigned to this Operation 1 Governor <br /> Harris D.Sherman <br /> Per M - - (Please reference the file number currently assigned to this operatioM);ecutive Director <br /> ( ) <br /> �f New Application(Rule 1.4.5) Amendment Application Rule 1.10 Ronald W.Canary <br /> Division Director <br /> Conversion Application(Rule 1.11) Natural Resource Trustee <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 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 11" 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): L.G. Everist, Incorporated <br /> 1.1 Type of organization(corporation,partnership,etc.): Corporation <br /> 2. Operation name(pit,mine or site name): Ragsdale Reservoirs <br /> 3. Permitted acreage(new or existing site): 643.30 permitted acres <br /> 3.1 Change in acreage(+) acres <br /> 3.2 Total acreage in Permit area 643.30 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: gravel sand, topsoil, overburden, borrow <br /> 5.1 Incidental commoditie(s)to be mined: 1. NA - lbs/Tons/yr 2. / lbs/Tons/yr <br /> 3. / lbs/Tons/yr 4. / lbs/Tons/vr 5. / lbs/Tons/w <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: Specification aggregates, fill and reclamation materials <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: NA <br /> Office of Office of <br /> Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />