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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> AM-1 <br /> 1313 Sherman St.,Room 215 AMG/JLE <br /> Denver,Colorado 80203 COLORADO <br /> Phone:(303)866-3567 CONSTRUCTION MATERIALS DIVISION OF <br /> RECLAMATION <br /> FAX:(303)832-8106 REGULAR(112)OPERATION MINING <br /> RECLAMATION PERMIT APPLICATION FORM I SAFETY <br /> Bill Ritter.Jr. <br /> CHECK ONE: ✓ There is a File Number Already Assigned to this Operation Governor <br /> Harris D.Sherman <br /> Permitm# M -2.012. 023 - (Please reference the file number currently assigned to this operatios*ecutive Director <br /> L__1 New Application(Rule 1.4.5) Amendment Application(Rule 1.10) Ronald W.cxeny <br /> Division Director <br /> Conversion Application(Rule 1.11) natural Resource Trustee <br /> Permit# M -2012- 023 - (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 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 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. Applicant/operator or company name(name to be used on permit): Tamrock Gravel LLC <br /> 1.1 Type of organization(corporation,partnership,etc.): Limited Liability Corporation <br /> 2. Operation name(pit.mine or site name): Shot Rock Pit <br /> 3. Permitted acreage(new or existing site): 21 00 permitted acres <br /> 3.1 Change in acreage(+) RECEIVED 3 14 acres <br /> 3.2 Total acreage in Permit area 24 14 acres <br /> 4. Fees: hM 2 5 2024 <br /> 4.1 New Application y., $2,696.00 application fee <br /> 4.2 New Quarry Application <br /> Colorado vision of RecSafety tion, •2.00application <br /> Mining and Safety quarry <br /> 4.4 Amendment Fee 2 29.00 : i i endment fee <br /> 4.5 Conversion to 112 operation(set by statute) $2.6' .00 conversion fee <br /> 5. Primary commoditie(s)to be mined: Crushed Stone Borrow <br /> 5.1 Incidental commoditie(s)to be mined: 1. none - lbs/Tons/vr 2. / lbs/Tons/yr <br /> 3. / lbs/Tons/vr 4. / lbs/Tons/yr 5. / lbs/Tons/yr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: Specification aggregates, fill <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: none <br /> Office of Office of <br />