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<br />^IVISION OF MINERALS AND GE040GY <br />Drparimenl of Nutural Resources <br />111 S Sherman Sr., Roum 21 i <br />Denver, Giloraclo HU.U7 <br />Phune' (JU31 tl66-3567 <br />FA%: lSOJ) a7?-a 106 <br />Operation Dame (nit, mine or site name): <br /> <br />~'TA^f't_,QF <br />III IIIIIIIIIIIIIIII <br />999 <br />COLORADO <br />a~~E~~~c <br />CREGULAR (112NOPERATIONS MaR ~ ~ 2004 <br />pyV <br />RECLAMATION PERMIT APPLICATION FORM~tN~p001tptt~t2~ <br />CHECK ONE: New A lication Rule 1.4.5 Amendment A lication Rule I.IO(~ `noel a tool; <br />PP ( ) PP ( D~!~~islon D~~eaor <br />C,conversion~A/pplication (Rule 1.1 l ) <br />Permit fa Mo~bZ~ ~ / -~ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Mazerials Regular 112 Operation Reclamation Permit contains three major parts: (I) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (I) complete sieved and notarized IVORY ORIGINAL and four (4) copies of the completed Ivorv <br />application form, five (5) copies of Exhibits A-S, Addendum I ,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 I/2" X 11" or 8 I/2" X 14" size. To expedi[e processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type ar print clearly, io the space provided, ALL information requested below. ~i~ <br />es ern o i e ,: <br />Applicant/oceretororcomoanvoame(nametobeusedoooermitl: a Subsidiary of Lafarge Corp. <br />1.1 Type oforganization (corporation,parmership,etc.): COrpOratlOn <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: <br /> <br />3 <br />Permitted acreaee (new or existine site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />448 permitted acres <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.3 Milling Application (Non-DMO) <br />4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditiNs) to be mined: Sand <br />$1.875.00 <br />52.325.00 <br />$3.100.00 <br />$1.550.00 <br />$1.875.00 <br />Gravel Fill 1laterial <br />~~ <br />DIVISION O F I <br />MINERALS <br />GEOLOGY' <br />RECLAMATIONI <br />MINING•$AFETY <br />Bill Owens <br />Covernnr <br />Crep E. Watcher <br />Executive Director <br />acres <br />acres <br />application fee v/ <br />quarry application <br />milling application <br />amendment fee <br />conversion fee '~~ <br />5.1 Incidental commoditie(s) to be mined: 1. N/A _ Ibslfons/vr 2. / Ibsrl'ons/vr <br />3. / Ibslfons/vr 4. / Ibs~i'ons/vr 5. / Ibslfons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Cons trUCtl On P r0 j eCtS <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />