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~ <br />STATE OF <br />DIVISION OF MINERALS AND GEOLOGY RECEIVED <br />t3apalbneM or IValwil tterounxs <br />1313 Shenllan SL, Room 215 <br />Oenver, catowdo Ilo2o3 CONSTRUCTION MATERULR ~ H~ 2 4 2004 <br />Pbonr. 43113) 866.3567 / <br />FAX: 1303) 832-0106 REGULAR (112) OPE$ATION Dhvisioa st Ninorils & QaalaaF <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: There b a 1PIk Number/nmady Anlgned to thb Operation <br />Permit Y,~- oil-021{P/l/eave teferatce the 61e number clur~nUy assigned to tltis operaoion) <br />x New Application (Rule L4.s) _ Awed®mt Applcation t:Rul61.lA) <br />Ceeverabn Application (Rule l.I 1) <br />Petalit M ~_-^_ _ _ (providc for Ameedmm4 arid Cottvenbes of existing permits) <br />JLORADt <br />V1310N O <br />LNF <br />EOLOG <br />fb FT,4C1[MC, <br />61U Own <br />Corenar <br />Glen E Waldmr <br />E,ec~aoe Oi/ec0or <br />aowa w. aml~r <br />Dlvifbll D'sedor <br />Natural Re,ourte Tnxaai <br />The applicatiml far a Ccostrta#ioe Melerials Regular 112 Opcation Reclamation Permit ccoraies three majorparts: (1) the application form; <br />(2) F.xlubits A-S, Addendwn I, any 3etxiotls ofExMbit Ii.S (Geotecbaical Stability Exhibit; ®d (3) Ute epplicatitm fee. When you sulmutyour <br />application,beslmtoillclllda/ale(1) esigpeda~mfariadlVORYOWGINALandane(1)oopycd'theamlpleVsiL~spplicalim <br />foam, two (2) copies ofFxllibitsA-S, Adtimdmn 1, appropriate sectionsofli.5 (t3aotxhnical Stability Exhibit, ®d a check for the application <br />feedaulibedtmder8eetion(4)below. FxhibitsshouklN~,abebotatdaine3•tiagbmda;mapsslwuldbeSoWodto812'XII'ar81/2'X <br />14" size. To expedite procesring, Please provide the informati~ in the fommi and order described is this farm <br />GENERAL OPERATION INFORMATION <br />Type or pelt deaeb, m the apm provided, ~, hdormadoo regrested bebw. <br />1. deolimdoneratororcomoaaveame(nametohemedaroermNt: Hilltop Aquatic Investments, LLC <br />I I Type ofargmvwti0n(claporetiatl,partaersbip etc): Limited Liability Company <br />1.2 IRS. Tax ID. No. a Social Selauity Nmlber. <br />2. Ooerdlaueamefeht,mmeorsireeluteel: Raindance Sand and Gravel Mine <br />3. Peemktcd aceraae (new or esbftrg dt!): <br />3.1 Change m aexeage (+) <br />3.2 Total aaeege in Permit area <br />85 ~~ acres <br />acres <br />85 <br />aIICS <br />4. ~c~ <br />4.l Ncw Applicatiao X2.344.(10 epplicellam ftx <br />4,2 New Quarts Application 52.906.00 quarts application <br />4.4 Arteead,nent Fa 52.938.00 ameadoleltt fce <br />4.5 Ccoversitln to 112 operation (set by Statute) X344"00 conversion fa <br />5. Pt(m arv eoe,aloditie6l to be mired: sa ~ $yavel <br />5.1 lttid®tal commoditie(s) to be mined: 1.1~lone - Ibslfons/vr 2.. ! Ib s/fonslvr <br /> 3. / Ibs/faev/vr 4. / lbslfonalvr 5. / Ib s/1'onarvr <br />5.2 Aitlelpated aid a3e of primalylbimnodltie(S)tObelivled: (Consr n ion A¢YrPg a,re and ('o ncrp_te Aay~p,¢a to <br />5.3 Anticipated end use cd'iecidentel commoditie(s) to be mined: None anticipated <br />Utfla d ORta of Cdondo <br />Mined lanA Rl•Clalilirlall AClif'e and Inactive Mine, Geol¢pWl Survey <br />