PERMFILE44632

• Permit No: M2006039
• IBM Index Class Name: Permit File
• Doc Date: 4/24/2006
• Doc Name: Inadequate Submittal
• From: Chevron Shale Oil Co.
• To: DMG
• Media Type: D
• Archive: No

RECEIVED

CONSTRUCTION MATERIALS
LIMITED IMPACT (110) OPERATION
RECLAMATION PERMIT APPLICATION FORM
APR 1 8 2006
Oivisian of Minerals and Geology
CHECK ONE: There is a File Number Already Assigned to this Operation
Permit # M -_-_-_ (Please reference the file number currently assigned to this operation)
.~,_ New Application (Rule 1.4.5) Amendment Application (Rule 1.10)
Conversion Application (Rule 1.11)
Permit # M - _ (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Limited Impact (I10) Operation Reclamation Pemtit wntains three major pate: (1) the
application form; (2) Exhibits A-J, Exhibit L, Addendtun 1, any sections ofExhibit 6.5 and Geotechnical Stability Exhibit, as requved
by the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be
sure to include one (1) com Ip_ete siatted and notazized ORIGINAL and one (1) copy ofthe completed application form, two (2) copies
of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for
the application fee described under (4) below. Exlv`bits should NOT be bound or in a 3-ring binder, maps should be folded to 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.
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, ALL information described below.
1. Ao olicanUooerator or comoanvname (name to be used on oermitl;Chevron Shale Oil Company, a division of Chevron U.S.A. Inc
1.1 Type of organization (corporation, partnership, etc.): Corporation
2. On eration name (oit, mine or site Hamel: North Cleaz Creek Construction Materials Mine
3. Permitted acreaee thew or eaistine site]: permitted acres
3.1 Change in acreage (+) 8.0 acres
3.2 Total Acreage in Permit Area 8.0 acres
4. Fees:
4.1 New Application: 1 094.00 application fee
Amendment Fee (C.R.S. 34-32.5-125(II)): 719.00 application fee
4.2 Conversion Fee (from 110d to 110 875.00 conversion fee (Rule 1.11.2(2))
i. Primarv commoditielsl to be mined: Construction Materials
51 Incidental commoditie(s) to be mined: 1. 0 / Ibs/Tons/vr 2. / lbs/Tons/yr 3. / lbs/Tons/yr
4. / ]bs/Tons/vr 5. / ]bs/TonsJyr
5.2 Anticipated end use of primary commoditie(s) to be mined: Construction Materials
Anticipated end use of incidental commoditie(s) to be mined: NA