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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources AM-1 <br /> 1313 Sherman St.,Room 215 NCG/JLE COLORADO <br /> Denver,Colorado 80203 DIVISION O F <br /> Phone:(303)866-3567 CONSTRUCTION MATERIALS RECLAMATION <br /> FAX:(303)832-8106 REGULAR(112)OPERATION MINING <br /> RECLAMATION PERMIT APPLICATION FORM SAFETY <br /> Bill Ritter,Jr. <br /> CHECK ONE: There is a File Number Already Assigned to this Operation Governor <br /> Harris D.Sherman <br /> Permit# M - - -_ (Please reference the file number currently assigned to this operatioa}ecutive Director <br /> 1- New Application(Rule 1.4.5) F✓_Amendment Application(Rule 1.10) R°rnwion WDirector cunt <br /> Divis <br /> p_Conversion Application(Rule 1.11) Natural Resource Trustee <br /> Permit# M -2020 -007 - (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): L.G. Everist, Incorporated <br /> 1.1 Type of organization(corporation,partnership,etc.): Corporation <br /> 2. Operation name(pit,mine or site name): Ragsdale Reservoirs <br /> 641.35 <br /> 3. Permitted acreage(new or existing site): RECEIVE') <br /> C %VED 26.62permitted acres <br /> 3.1 Change in acreage(+) acres <br /> 3.2 Total acreage in Permit area C�� 667.97 <br /> n lj/J acres <br /> f '� ., <br /> 4. Fees: <br /> 4.1 New Application O DtVISt�n p;Rectama l0l't $041xi1f0 application fee <br /> 4.2 New Quarry Application (',O1Ofad and Sa(et �0 quarry application <br /> 4.4 Amendment Feen1nJ $2.229.00 amendment fee <br /> 4.5 Conversion to 112 operation(set by statute) E3i611/�0 conversion fee <br /> 5. Primary commodities)to be mined: Gravel Sand topsoil overburden borrow <br /> 5.1 Incidental commoditie(s)to be mined: 1. NA - lbs/Tons/vr 2. / lbs/Tons/yr <br /> 3. / lbs/Tons/yr 4. / lbs/Tons/yr 5. / lbs/Tons/yr <br /> 5.2 Anticipated end use of primary commoditie(s)to be mined: Specification aggregates <br /> 5.3 Anticipated end use of incidental commodities)to be mined: NA <br /> Office of Office of <br /> Mined Land Reclamation Denver• Grand Junction • Durango Active and Inactive Mines <br />