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STATE OF COLORADO <br /> DIVISION nF RFCI AMATION MINING ANn SAFFTYD, COMPUED111 NO VIOLATIONS RECEIVED <br /> 1: <br /> p C VISION O <br /> p) AM0""""" �j�� � «« i ��� DIVISION ION OF <br /> RECLAMATION <br /> R N MINOR INFRACTIONS JPL ),LE/AWA MINING <br /> DIVISIOPd OF RECLAMATION S & Y <br /> MINING AND SAFETY SAFETY <br /> CONSTRUCTION MATERIALS <br /> REGULAR(112)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM <br /> CHECK ONE:�_ There is a File Number Already Assigned to this Operation <br /> Permit# M2,016 oQ9 (Please reference the file number currently assigned to this operation) <br /> New Application(Rule 1.4.5) ✓�Amendment Application(Rule 1.10) <br /> Conversion Application(Rule 1.11) <br /> Permit# M 2016 _ 009 _ (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): Fremont Paving and Redi MIX <br /> 1.1 Type of organization(corporation,partnership,etc.): Corporation <br /> 2. Operation name(pit,mine or site name): 44th Lane Project <br /> 3. Permitted acreage(new or existing site): 1471 permitted acres <br /> 3.1 Change in acreage(+) +57.39 acres <br /> 3.2 Total acreage in Permit area 1528.39 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 <br /> 5.1 Incidental commoditie(s)to be mined: 1. lbs/Tans/yr 2. / lbs/Tons/yr <br /> 3. / ibs/Tons/vr 4. / lbs/Tons/yr 5. / lbs/Tons/yr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: <br />