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COLORADO <br /> s Division of Reclamation, <br /> Mining and Safety <br /> Department cif Natural R@SOUrccs <br /> 1313 Sherman Street, Room 215 <br /> Denver, CO 80203 <br /> REQUEST FOR TECHNICAL REVISION (TR) Importation of Inert Fill <br /> File No.: M- 1981-148 site Name: Chieftain South Mine <br /> County: Jefferson TR# (DRMS Use only) <br /> Permittee: General Shale Brick, Inc. <br /> Operator (If Other than Permittee): <br /> Permittee Representative: Harold Stickler <br /> The request for a TR is not considered "filed for review" until the appropriate fee is received by <br /> the Division (as listed below by permit type). Please submit the appropriate fee with your request <br /> to expedite the review process. After the TR is submitted with the appropriate fee, the Division <br /> will determine if it is approvable within 30 days. If the Division requires additional information to <br /> approve a TR, you will be notified of specific deficiencies that will need to be addressed. If at the <br /> end of the 30 day review period there are still outstanding deficiencies, the Division must deny <br /> the TR unless the permittee requests additional time, in writing, to provide the required <br /> information. <br /> There is no pre-defined format for the submittal of a TR. Page 2 is designed to address the <br /> requirements of Rule 3.1.5(9). It is up to the permittee to provide sufficient information to the <br /> Division to approve the TR request, including updated mining and reclamation plan maps that <br /> accurately depict the changes proposed in the requested TR. <br /> Required Fees for Technical Revision by Permit Type - Please mark the correct fee and submit it <br /> with your request for a Technical Revision. <br /> Permit Type Required TR Fee Submitted (mark only one) <br /> 110c, 111, 112 construction ❑ <br /> $216 <br /> materials, and 112 quarries ✓ <br /> 112 hard rock (not DMO) $175 <br /> 110d, 112d(1, 2 or 3) $1006 ❑ <br /> 2018-2019 Wildfire ❑ <br /> Waived <br /> Material Debris Removal <br /> -1- <br />