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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman S � <br /> Denv COLORADO <br /> Phon � 567 DIV1S10N oe <br /> RECLAMATION <br /> FAX:( 03)832-8106 202't M I N 1 N G <br /> �pR �5 A-�r�c��, sA E Y <br /> D���S��&SaRE Y M N�R A�� <br /> CONSTRUCTION MATERIALS <br /> M�N��G REGULAR(112)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM <br /> CHECK ONE: ✓�_ There is a File Number Already Assigned to this Operation <br /> Permit# M 198 n2E - (Please reference the file number currently assigned to this operation) <br /> �New Application(Rule 1.4.5) a Amendment Application(Rule 1.10) <br /> �Conversion Application(Rule 1.11) <br /> Permit# M��87 �6 - (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 Ea�chibit 6.5(Geotechnical Stability E�chibit;and(3)the application fee. When you <br /> submit your application, be sure to include one (1) comnlete siQned 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 Eachibit,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. Aaalicant/onerator or comaanv name(name to be used on aermitl: COIO�aClO QUaPPI@S �nC. <br /> 1.1 Type of organization(corporation,partnership,etc.): COrp. <br /> 2. Oaeration name(ait,mine or site namel: B�aCk�Obsidian Pit <br /> 3. Permitted acreaEe(new or existine site): � 9•0 permitted acres <br /> 3.1 Change in acreage(+) 131.0 acres <br /> 3.2 Total acreage in Permit area 140.0 acres <br /> 4. Fees: <br /> 4.1 New Application $2.696.00 application fee <br /> 42 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: ObSldlB� <br /> 5.1 Incidental commoditie(s)to be mined: 1. 250,0� yr lbs/Tons/vr 2. / lbs/Tons/vr <br /> 3. / lbs/Tons/vr 4. / lbs/Tons/vr 5. / lbs/Tons/vr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: In COI1Ct'et@ 1711X, decorative <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: na <br />