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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 <br /> Denver.Colorado 80203 C O L O R A D O <br /> Phone:(303)866-3567 D t v 1 s t ON OF <br /> FAX:(303)832-8106 RECLAMATION <br /> MINING <br /> SAFETY <br /> CONSTRUCTION MATERIALS <br /> REGULAR(112)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM <br /> CHECK ONE:Q- There is a File Number Already Assigned to this Operation <br /> Permit 4 M - - (Please reference the file number currently assigned to this operation) <br /> 0 t✓ <br /> New Application(Rule 1.4.5) Amendment Application(Rule 1.10) <br /> la-Conversion Application(Rule 1.11) <br /> Permit 4 M - - - (pro%ide 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 ol'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 Ibr <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 I I"or 8 112"X 14"sire. 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. Ayolicant/operator or company name(name to be used on permit). VIP MINE LLC <br /> 1.1 Type of organization(corporation,partnership,etc.): <br /> 2. Operation name(pit,mine or site name): VIP MINE <br /> 3. Permitted acreage(new or existing site): 40.38 permitted acres <br /> 3.1 Change in acreage(+) acres <br /> 3.2 Total acreage in Permit area 40.38 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 fec <br /> 4.5 Conversion to 112 operation(set by statute) $2,696.00 conversion fee <br /> 5. Primary commoditie(s)to be mined: gravel cobble <br /> 5.1 Incidental commodities} 38500o to be mined: 1. Tons/yr 1bs/Tons! 2 41 tons/yrIbs'Tonsivr <br /> 3. ! lbs/Tuns`yr 4. / Ibs/Tons(yr 5. ! lbs/Tons/yr <br /> 5.2 Anticipated end use ofprimar-, commoditic(s)to be mined: IOatlbase, structural fill <br /> 5.3 Anticipated end use or incidental coinrnoditic(s)to be mined: landscaping <br />