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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural Resources <br /> Sherman St.,Room 215 Den M 1978-079 CN0 7 C O L O R A D O <br /> DIV IS I ON OF <br /> Denver,Colorado 80203 — <br /> Phone:(303)866-3567 / RECLAMATION <br /> V <br /> FAX:(303)832-8106 Compliedt 0 Violations MINING <br /> 3 Minor Infractions 2C1/jle/awa _&_ <br /> } SAFETY <br /> CONSTRUCTION MATERIALS RECEIVED <br /> REGULAR(112)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM APR 0 5 2021 <br /> CHECK ONE:IV[ — There is a File Number Already Assigned to this Operation DIVISION OF RECLAMATION <br /> MINING AND SAFETY <br /> Permit# M -"-I O-l4_ (Please reference the file number currently assigned to this operation) <br /> New Application(Rule 1.4.5) Amendment Application(Rule LI0) <br /> Conversion Application(Rule 1.11) <br /> Permit# M -k0i"18-D-79 - (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): Linc•n1ri r e-1U'T " <br /> 1.1 Type of organization(corporation,partnership,etc.): Lt9Gd c oyero I ner-Et <br /> 2. Operation name(pit,mine or site name): :]� b,C t t sj <br /> 3. Permitted acreaEe(new or existiny.site): permitted acres <br /> 3.1 Change in acreage(+) (' acres <br /> 3.2 Total acreage in Permit area • 8 7 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: _ Ca,'ra 1/ - <br /> 5.1 Incidental commoditie(s)to be mined: 1. Q — N, � lbs/Tons/yr 2. / lbs/Tons/yr <br /> 3. / lbs/Tons/yr 4. / lbs/Tons/yr 5. / lbs/Tons/yr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: ;a-L <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: <br />