2021-05-06_PERMIT FILE - M2021031 (12)

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STATE OF COLORADO DIVISION OF RECLAMATION,MINING AND SAFETY Department of Natural Resources 1313 Sherman Room 215 M 20 21 -0 31 Denver,Colorado do 80203 rR;ECLAMAT OL O R A D O IVISION O F Phone:(303)866-3567 FAX:(303)832-8106 ECS/mac/awa/sinsMININ, SAFETI CONSTRUCTION MATERIALS RECEIVED SPECIAL(111)OPERATION RECLAMATION PERMIT APPLICATION FORM MAY 0 6 2021 DIVISION OF RECLAMATION MINING AND Ur,i�TY The application for a Construction Materials Special 111 Operation Reclamation Permit contains four major parts:(1)the application forr. (2)Exhibits A-L,Addendum 1,and any sections of Exhibit 6.5(Geotechnical Stability Exhibit),as required by the Office,and outlined 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.Whe you submit your application,be sure to include one(1)completed,signed and notarized ORIGINAL and one(1)copy of the complete application form;two(2)copies of Exhibits A-L,Addendum 1,appropriate sections of Exhibit 6.5(Geotechnical Stability Exhibit),z required,a check for the application fee described under(4)below,and the fully executed Performance Warranty and Financial Warranty, required. Exhibits should NOT be bound or in 3-ring binders;maps should be folded to 8 2" X I I" or 8 2" X 14" size. To expedit processing,please provide the information in the format and order described in this form. GENERAL OPERATION INFORMATION Type or print clearly,in the space provided,all information described below 1. Applicant/operator or company name(name to be used on the permit): Ames Construction,Inc. 1.1 Type of organization(corporation,partnership,etc.): corporation 2. Operation name(ait,mine or site name): Burnham Property Borrow 3. Permitted acreage: 16.00 Permitted Acres 4. New Application: $898.00 Application Fee 5. Primary commoditle(s)to be mined: FIII Dirt 6. Name of owner to the surface of affected land: Arlene Burnham 7. Name of owner to the subsurface rights of affected land: Arlene Burnham 8. Type of mining operation: M Surface Q Underground ][D In-situ 9. Location information: The center of the area where the majority of mining will occur: COU weld lorado)PRINCIPAL MERIDIAN(check one): '� 6th(Co � IOth(New Mexico) R Ute SECTION(write number): S 6 TOWNSHIP(write number and check direction): T 9 North South RANGE(write number and check direction): R 67 East Z. West ]Et QUARTER SECTION(check one): ✓ NE NW SE SW QUARTER/QUARTER SECTION(check one): NE ✓ NW SE SW GENERAL DESCRIPTION:(the number of miles an irection from the nearest town and the approximate elevation): 6.5 miles NE of Wellington, CO Aoprox Elevation 5600 Office of Office of Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines