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STATE OF COLOMDO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources REC rA'�'w'D <br /> 1313 Sherman St.,Room 215 <br /> Denver,Colorado 80203 COLORADO <br /> DIVISION OF <br /> Phone:(303)866-3567 APR 0 8 2024 RECLAMATION <br /> FAX:(303)832.8106 MINING <br /> Colorado Division matt n, SAFETY <br /> CONSTRUCTION MATERIALS Mining and Safety <br /> SPECIAL(111)OPERATION <br /> M-2024-012 <br /> RECLAMATION PERMIT APPLICATION FORM AC THM <br /> O24.. <br /> The application for a Construction Materials Special 1 1 1 Operation Reclamation Permit contains four major parts:(1)the application form; <br /> (2)Exhibits A-L,Addendum 1,and any sections of Exhibit 6.5(Geotechnical Stability Exhibit),as required by the Office,and outlined in <br /> Rules 6.1,6.2,6.3,6.5,and I.6.2(1)(b); (3)the application fee;(4)the Performance Warranty and if required a Financial Warranty.When <br /> you submit your application,be sure to include one(1)completed.signed and notarized ORIGINAL and one(1)copy of the completed <br /> application form,two(2)copies of Exhibits A-L,Addendum 1,appropriate sections of Exhibit 6.5(Geotechnical Stability Exhibit),as <br /> required,a check for the application fee described under(4)below,and the fully executed Performance Warranty and Financial Warranty,if <br /> required. Exhibits should be bound or in 3-ring binders;maps should be folded to 8 2"X 11"or 8 2" X 14"size. To expedite <br /> 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 /> 1. Applicant/operator or comnanv name(name to be used on the permit): <br /> W.W.Clyde&Co. <br /> 1.1 Type of organization(corporation,partnership,etc.): Corporation <br /> 2. Operation name(pit.mine or site name): Collett Property <br /> 3. permitted acreage: 9.07 Permitted Acres <br /> 4. New Application: $898.00 Application Fee <br /> 5. Primary commodities)to be mined: Fill dirt and backfill material <br /> 6. Name of owner to the surface of affected land: Shane Collett <br /> 7. Name of owner to the subsurface ights of affected land: Shane Collett <br /> 8. Type of mining operation: I v 1 Surface a Underground 0.1n-situ <br /> 9. Location information: The center of the area where the majority of mining will occur: <br /> CO . Rio Blanco <br /> PRINCIPAL MERIDIAN(check one): 0 6th(Colorado) n 10th(New Mexico) ,a Ute <br /> SECTION(write number): S 9 <br /> TOWNSHIP(write number and check direction): T 4 North _Amer` South <br /> RANGE(write number and check direction): R 94 East ✓ West <br /> QUARTER SECTION(check one): IIINE NW _ SE ✓ SW <br /> QUARTER/QUARTER SECTION(check one): ■ NE _ NW _ ✓ _ SE zr SW <br /> GENERAL DESCRIPTION:(the number of miles an. • rection from the nearest town and the approximate elevation): <br /> Residential property. on the east side of SH13 approximately 17 miles north of Rifle. CO. <br /> Office of Office of <br /> Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />