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r <br />Fax:3038663558 Nov '99 1A:50 <br />.N ~ STATE ~F C~L~~tnUU <br />DIVISION OF µ1NERA1$ AND GEOLOGY <br />Depanmem of Nstural Resources <br />131.1 Sherm^n $r., Room ?7$ <br />Denver, Cuiurodu HUYU7 <br />PFWne: IJU71 afi4•JShT <br />FAX: IJO)I BJ2-A 106 <br />~~ <br />DIVISION OI <br />MINERAL <br />Of. <br />GEOLOGt <br />4EClANATtON <br />MINING•SAFf TT <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATIONPERMfTAPPLICATIONFORM e~'to°^^* <br />Co+ernnr <br />Gt6 E. Walcner <br />E+<cu6"e Oi~ector <br />CHECK ONE: X New A liation Rule 1.4.5 ~ Amendment A lication RLIe 1.10(t.~ ""d e, wnp <br />PP ( ) PP ( oirnlon Diretwr <br />Convenioo AppGeatian {Rule 1..11) <br />Permit # _[vt_-~ , (provide for Amendments and Coaveriioos of existing permits) <br />The appitaton for a Cortyvtxtiat Mazerials Regular 112 Opecuion Reclamation Permit cottuios three major parts: (1) the application form; <br />(2) l:xhtbits A-S, Addendum 1, any sections ofFxhibit tiS (Geatechnical Stability Exhibit gad (3) the application frc. When you submit your <br />application, be sure to include one (1) comgte si¢ned and notarized NORY ORIGIlYAL and folrr (4) Bogies of the completed vorv <br />application form, 5ve (5) copies of Exhibits AS, Addendum 1, appropriate seetiotts of 6.5 (Geotechnitxl Smbtliry Exhibit, and a check for <br />the application fee described under Section (4} below. Exhibits should NOT be bound or in a 3-riDg binder, maps should be folded to <br />8 1!2' X 11 " or 8 I!2" X 14' size. To expedite processing, please provide the information in the format and order desrnbed in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print elarly, in the spas provided, information requested bdo.r. <br />1. ~9lipnt7ooera[ororeomosnvnsmefnametohe~usedoopermitl: C~~S ColOZ'ad0. IAC. <br />l.] Type of ocgaoitadon (eorporatiaq parfiership, arc.): COr'PO}•St10I1 <br />11 I.RS. Tax I.D_ No. or Social Seeuriry Number: <br />3.1 Change in acreage (+) <br />3.2 Total acl-ea,e in Permit area <br />?. Oner9hon.aame (D11. mlae Or Site camel; R7.Y@IV1CW I~QSOt1TCB <br />340 permitud acres <br />3. Pecmetted aereaee tnew~ or existingsite): <br />atzes <br />acres <br />4. ~qea: l .. -- .. . <br />4.1 New Application ~l 87 applitation ftx <br />41 ' Ncw Quarry Application 00 u a lirxtion <br />Q any PP <br />43 MillingApplicaz(on(Non-DMO) 13.100.00 millingapplicarion <br />4.4 AmendmentFtm ~ P- ,00' amendmenY'fee"~- <br />4.$ Conversion to l 12 operation (set by stature) I 7 ,00 conversion fee <br />5. Primate mmmoditiefsl to be min Sand gravel <br />i.i locidental commoditie(s) to be mined: I. n/a - Ibs/fo~/vr 2. / Ibslfanslvr <br />3. / Ibsfionslvr 4. ! 16s.Tottehr $. ( lbsfl'ortsrvr <br />51 Anfieipared end use of primary commoditie(s) to be mined: c-rinctn~~ti nn m7rPri ~l c <br />$3 Anticipated end use ofineidrnral cemmoditie(a) w be mined: *+ /.+ <br />