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STATE OF COLORADO <br /> DMSION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources C;p o 1 j V,T Y <br /> 1313 Sherman St.,Room 215 C O L O RA D O <br /> Denver,Colorado 802M D i v r S 1 O N OF <br /> Phone:{3o3)8tifr356Z ? AUG 12 AM 8' t U RECLAMATION <br /> FAX(303)832-8106 MINING <br /> SAFETY <br /> CONSTRUCTION MATERIALS <br /> REGULAR(112)OPERATION <br /> RECLAMATION PERNIIT APPLICATION FORM <br /> CHECK ONE:§D_ There is a HIS Number AlMdp Assignee to this Operation <br /> Permit#-M = 2 0 Q9—Q$,f. (Please reference the file number currently assigned to this operation) <br /> New Application(Rule 1.4.5) M—Amendment Application(Rule 1.10) <br /> Conversion Application(Rule 1.11) <br /> Permit# M 2 009_--086 - (provide for Amead ments and Conversbus of existing permits) <br /> The application for a Construction Materials Regular 112 Operation Reclamation Permit contains tbree major Parts:(1)the application <br /> form;(2)Exhibits A-S,Addendum 1,any sections of Exhibit 6.5(Geotechnical Stability Exbibit;and(3)the application fee. When you <br /> submit your application,be sure to include one (1) comolete sZgW and notarizd ORIGIlYAL 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. Eshubits should NOT be bound or in a 3-rmg binder;maps should be folded to <br /> 8 I/2"X i 1"or 81/2"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, L,information requested below. <br /> 1. AanIIcant/ouerator or comnanr uamce(name to be used on nermft): rz1 i n t Qt nn e r rav®l—� <br /> 1.1 Type of organization(corporation,partnership,etc-r. Corporatdon <br /> 2_ 9neration name(sit.mine or site name): Pickering Family P i t <br /> 3. Permitted acreage(new or eiisduff site): 1 9_g n permitted acres <br /> + 16.84 acres <br /> 3.1 Change in acreage{+) <br /> 3.2 Total acreage in Permit area 3 6 7 _ acres <br /> 4. Fees: $2 .0 application fee <br /> 4.1 New Application <br /> $3342.00 quarry application <br /> 4.2 New Quarry Application <br /> 4.4 Amendment Fee 229.0 amendment fee <br /> 4.5 Conversion to 112 operation(set by statute) 2 96.0 conversion fee <br /> 5. Primary commodities)to be mined: sand gravel <br /> 5.1 Incidental commodities)to be mined: 1. - IbsPl'on4fvr 2. / 1bs/Tons/yr <br /> 3. / 1bs9ons/yr 4. I 1bsfTons/vr 5._ / lbsfrons/yr <br /> 5.2 Anticipated end use of primmy commoditie(s)to be mined: <br /> 5.3 Anticipated end use of incidental crommoditie(s)to be mined: <br />