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STATE OF COLORADO <br /> DIVISION Of RECLAMATION,MINtwtr_ AhJn c A r- <br /> Department of Natural Resources <br /> 1313 Sherman ,Room 215 M 20 2 1 -p 16 <br /> Denver,Colorado 80203 C O L O R A D O <br /> Phone:(303)866-3567 D t v I S t O N o f <br /> FAX:(303)832-8/06 RECLAMATION <br /> DMC/thm/awa MINING <br /> SAFETY <br /> CONSTRUCTION MATERIALS G <br /> SPECIAL(111)OPERATION <br /> MAR U 2 2021 <br /> RECLAMATION PERMIT APPLICATION FORM <br /> DIVISION OF RECLAMATION <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 11" 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 permitl: <br /> Cornerstone Materials LLC <br /> 1.1 Type of organization(corporation,partnership,etc.): LLC <br /> 2. Operation name(pit,mine or site name): Blue Creek Staging Area <br /> 3. Permitted acreage: 19.93 Permitted Acres <br /> 4. New Application: $898.00 Application Fee <br /> 5. Primary commodities)to be mined: Construction Aggregatges <br /> 6. Name of owner to the surface of affected land: B&L Land Company LLC <br /> 7. Name of owner to the subsurface riehts of affected land: B&L Land Company LLC <br /> 8. Type of mining operation: n Surface a Underground n In-situ <br /> 9. Location information: The center of the area where the majority of mining will occur: <br /> CO Gunnison <br /> PRINCIPAL MERIDIAN(check one): 6th(Colorado) ✓ 1 Oth(New Mexico) II Ute <br /> SECTION(write number): S 1 <br /> TOWNSHIP(write number and check direction): T 48 North South <br /> RANGE(write number and check direction): R 5 East ✓ West <br /> QUARTER SECTION(check one): NE NW ✓ SE SW <br /> QUARTER/QUARTER SECTION(check one): NE NW SE ✓ SW <br /> GENERAL DESCRIPTION:(the number of miles an irecti0n from the nearest town and the approximate elevation): <br /> 30 Miles South West of Gunnison on US 50 <br /> Office of Office of <br /> Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />