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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural R-- <br /> Den Sherman St., 0203 M 20 2 1 _04 <br /> Denver,Colorado 80203 1 jJ 1 O L O R A D <br /> RCLDVIS (ON Q F <br /> Phone:(303)866-3567 EAMATION <br /> FAX:(303)832-8106 DMC/thm/awa <br /> MINING <br /> - <br /> SAFETY <br /> CONSTRUCTION MATERIALS <br /> LIMITED IMPACT(110)OPERATION JUN 3 0 202l <br /> RECLAMATION PERMIT APPLICATION FORM DIVISION OF RECLAMATION <br /> MINING&SAFETY <br /> CHECK ONE: There is a File Number Already Assigned to this Operation <br /> Permit# M - - (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 - - - (provide for Amendments and Conversions of existing permits) <br /> The application for a Construction Materials Limited Impact(I10)Operation Reclamation Permit contains three major parts: (1)the <br /> application form;(2)Exhibits A-J,Exhibit L,Addendum 1,any sections of Exhibit 6.5 and Geotechnical Stability Exhibit,as required by <br /> the Office,and outlined in Rules 6.1,6.2,6.3,6.5,and 1.6.2(1)(b);and(3)the application fee. When you submit your application,be sure <br /> to include one (1)c:m-!ete signed and notarized ORIGINAL and one(1) copy of the completed application form,two(2)copies of <br /> Exhibits A-J,Exhibit L,Addendum 1,and appropriate sections of 6.5 (Geotechnical Stability Exhibit),as required,and a check for the <br /> application fee described under(4)below. Exhibits should NOT be bound or in a 3-ring binder;maps should be folded to 8 1/2"X I I"or 8 <br /> 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 described below. <br /> I. Applicant/oaerator or comaany name(name to be used on aermit): Weimer Ranches, LLLP <br /> 1.1 Type of organization(corporation,partnership,etc.): Limited Liability Limited Partnership <br /> 2. Operation name(uit,mine or site name): Weimer Ranches#4 Mine <br /> 3. Permitted acreage(new or existing site): 10 permitted acres <br /> 3.1 Change in acreage(+) acres <br /> 3.2 Total Acreage in Permit Area 10 acres <br /> 4. Fees: <br /> 4.1 New Application: $1258.00 application fee <br /> Amendment Fee(C.R.S.34-32.5-125(II)): $827.00 application fee <br /> 5. Primary commoditie(s)to be mined: Sand Gravel <br /> 5.1 Incidental commoditie(s)to be mined: 1. / lbs/Tons/yr 2. / lbs/Tons/yr 3. / lbs/Tons/yr <br /> 4. / Ibs/Tons/yr 5. / lbs/Tons/yr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: Construction Materials <br /> Anticipated end use of incidental commoditie(s)to be mined: <br />