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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources RECEIVED <br /> 1313 Sherman St.,Room 215 <br /> Denver,Colorado 80203 p O L Or o N)00 <br /> Phone:(303)866-3567 AUG 1 6 2024 RECLAMATION <br /> FAX:(303)832-8106 MINING <br /> Colorado Division of Reclamation, SAFETY <br /> Mining and Safety <br /> CONSTRUCTION MATERIALS <br /> REGULAR(112)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM <br /> CHECK ONE:0 There is a File Number Already Assigned to this Operation <br /> Permit# M - - -_ (Please reference the file number currently assigned to this operation) <br /> New Application(Rule 1.4.5)EL <br /> Amendment Application(Rule 1.10) <br /> Conversion Application(Rule 1.11) <br /> Permit# M -WO-0y3 - (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 E4hibit;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. +,, {� �p <br /> 1. Applicant/operator or company name(name to be used on permit): Ch Onk 1'r 1 ak V\ V 1�i1 e, 'V <br /> 1.1 Type of organization(corporation,partnership,etc.): S WI' <br /> 0 Y U.-i 0 h <br /> 2. Operation name(pit,mine or site name): f o\ . P, /+� <br /> 3. Permitted acreage(new or existing site): 0 1'(I permitted acres <br /> 3.1 Change in acreage(+) 2 acres <br /> 3.2 Total acreage in Permit area 11 ,1 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 fee <br /> 4.5 Conversion to 112 operation(set by statute) I ✓$2.696.00 conversion fee <br /> 5. Primary commoditie(s)to be mined: . rAVv` Sc Vld C l a� <br /> 5.1 Incidental commoditie(s)to be mined: 1 0 lbs/Tons/yr 2. 0 lbs/Tons/yr <br /> 3. 0 lbs/Tons/yr 4. g6 lbs/Tons//y1rr 5. e lbs/Tons/yr <br /> 5 2 Anticipated end use of primary commoditie(s)to be mined: 2,03q <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: 0 i h(A dev(*1 r�rnrno dsfie s Dui t( ► e M' <br />