Laserfiche WebLink
. COLORADC <br /> Division of Reclamation. <br /> Mining and Safe,.- <br /> 1313 Sherman Street.Room 215 <br /> Denver.Colorado 80203 <br /> CONSTRUCTION MATERIALS <br /> SPECIAL OPERATION 111(1)(b) <br /> RECLAMATION PERMIT APPLICATION FORM <br /> The application for a Construction Materials Special l i t Operation Reclamation Permit contains four major parts: (1) the <br /> application form;(2)Exhibits A-L,Addendum 1,and any sections of Exhibit 6.5 (Geotechnical Stability Exhibit),as required <br /> by the Office,and outlined in Rules 6.1,6.2, 6.3,6.5,and 1.6.2(1)(b); (3)the application fee; (4)the Performance Warranty <br /> and Financial Warranty. <br /> When you submit your application,be sure to include one completed,signed and notarized ORIGINAL and one copy of the <br /> completed application form, two copies of Exhibits A-L, Addendum 1, appropriate sections of Exhibit 6.5 (Geotechnical <br /> Stability Exhibit), as required, a check for the $400.00 application fee, and the fully executed Performance Warranty and <br /> Financial Warranty. Exhibits should NOT be bound or in 3-ring binders;maps should be folded to 8 Y?X 11"or 8 %"X 14" <br /> 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 described below <br /> 1. Applicantloperator or company name(name to be used on the permit): <br /> 64nbin Htd-uw <br /> 1.1 Type of organization(corporation,partnership,etc.):i (DVVb*ZV,iCn <br /> 2. Operation name(pit,mine or site name): Re-9e✓to;r(8r JirSan) <br /> 3. Permitted acreage:(must be 30 acres or less) -80 Permitted Acres <br /> 4. Fees: <br /> 4.1 New Application $400.00 Application Fee <br /> 5. Primary commodities)to be mined: S,A4 Lcarr) <br /> 6. Name of owner to the surface of affected land: lC <br /> 7. Name of owner to the subsurface rights of affected land: FAl lC <br /> 8. Location information: The center of the area where the majority of mining will occur: <br /> COUNTY: a paso <br /> PRINCIPAL MERIDIAN(check one): L•`t 6th(Colorado) n 1 Oth(New Mexico) 0 Ute <br /> SECTION(write number): S <br /> TOWNSHIP(write number and check direction): T 15 M North South <br /> � <br /> RANGE(write number and check direction): R - East X West <br /> QUARTER SECTION(check one): _M NE M _ NW F-1— SE a_SW <br /> QUARTERIQUARTER SECTION(check one): NE NW SE �_SW <br /> 1313 Sherman Street. Room 215,Denver,CO 80203 P 303.866.3567 F 303.832.8106 http://minin.o.state.co.us ; rj <br />