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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,Mttutwr.♦tun cArFry <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 C O L O R A D O <br /> Denver,Colorado 80203 M -2020-027 <br /> o t v t s t o to o f <br /> Phone:(303)866.3567 RECLAMATION <br /> FAX:(303)832-8106 MINING <br /> SJM/THM/AWA —&— <br /> SAFETY <br /> CONSTRUCTION MATERIALS RECEIVED <br /> SPECIAL(111)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM MAY 01 2020 <br /> DIVISION R ECLLAMA <br /> MINING AND SAFETY <br /> The application for a Construction Materials Special I I I Operation Reclamation Permit contains four major parts:(1)the application form; <br /> (2)Exhibits A-L,Addendum 1,and any sections of Exhibit 6.5(Geotechnical Stability Exhibit),as required by the Office,and outlined in <br /> Rules 6.1,6.2,6.3,6.5,and 1.6.2(1)(b); (3)the application fee;(4)the Performance Warranty and if required a Financial Warranty.When <br /> you submit your application,be sure to include one(1)completed,signed and notarized ORIGINAL and one(1)copy of the completed <br /> application form,two(2)copies of Exhibits A-L,Addendum 1,appropriate sections of Exhibit 6.5 (Geotechnical Stability Exhibit),as <br /> required,a check for the application fee described under(4)below,and the fully executed Performance Warranty and Financial Warranty,if <br /> required. Exhibits should NOT be bound or in 3-ring binders;maps should be folded to 8 2" X I I"or 8 2" X 14" size. To expedite <br /> 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 described below <br /> 1. Applicant/operator or company name(name to be used on the permit): <br /> Oldcastle SW Group, Inc.dba Four Corners Materials <br /> 1.1 Type of organization(corporation,partnership,etc.): Corporation <br /> 2. Operation name(pit,mine or site name): South Fork#1 Pit <br /> 3. Permitted acreaee: 30 Permitted Acres <br /> 4. New Application: $898.00 Application Fee <br /> 5. Primary commodities)to be mined: Construction Sand and Gravel <br /> 6. Name of owner to the surface of affected land- Colorado State Board of Land Commissioners <br /> 7. Name of owner to the subsurface riebts of affected land: Colorado State Board of Land Commissioners <br /> 8. Tvve of minine operation: 1 Surface [:I Underground I:]In-situ <br /> 9. Location information: The center of the area where the majority of mining will occur: <br /> CO Rio Grande <br /> PRINCIPAL MERIDIAN(check one): J_r6th(Colorado) IOth(New Mexico) II Ute <br /> SECTION(write number): S 27 <br /> TOWNSHIP(write number and check direction): T 40 North South <br /> RANGE(write number and check direction): R 4 ✓ East West <br /> QUARTER SECTION(check one): NE NW SE E <br /> SW <br /> QUARTER/QUARTER SECTION(check one): NE ✓ NW SESW <br /> GENERAL DESCRIPTION:(the number of miles an direction from the nearest town and the approximate elevation): <br /> approximately 5 miles East of South Fork, CO Elev- 8,100' <br /> Office of Office of <br /> Mined land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />