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TATE OF COLOI <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources RECEIVED <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 DEC 1 ~ 2002 ~ <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />pivisian of Minerals and Geolosy <br />CONSTRUCTION MATEBIAL5 <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Permit # M -7F.03~-_ (Please refeteace the file number currently assigned [o this aperation) <br />New Application {Rule 1.4.5) _ Amendment Application (Rule 1.10) <br />_ Conversion Application (Rule 1. ] 1) <br />Permit # I_vI _-! _ ~ (provide for Amend®eots and Conversions of elristing petm4s) <br />DIVISION O F <br />MINERALS <br />GEOLOGY <br />RECLAMATION <br />MINING•SAFETY <br />Bill Owens <br />Governor <br />Greg £. Walther <br />Executive DIreC10f <br />Ronald W. Cattany <br />Acting Division Director <br />The application for a Conshnction Materials Regular 112 Operation Reclamation Pemrit contains throe majorparts: (1) the app]ication form; <br />(2) Exhrbits A-S, Addendtnn 1, any sections of Farhrbit 65 (Geotechaical StabrlityExhrbit; and (3) ffie application foe. When you submit your <br />application, be sure to inchlde one (1) complete sued and notarized IVORY ORIGINAL and one (1) copy of the completed Ivo~X application <br />form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check far the application <br />fee described ender Section (4) below. Exhibffi should NOT be boultd ar in a 3-ring binder; maps should be fohled to 812" X 11" or 8 1/2" <br />X 14" size. To expedite pmeessing, please provide the information in the fonvat and order described in this foffi. <br />OENERAI.OPERATION INFORMATION <br />Type or print clearly, in the apace provided, ALL information requested below. <br />I. AnolicanUonerator or comoanv name (name to be wed on permit): t~Lf~/ld. ~N ~ f~A~ CTI~~ t 61~I (' , <br />_ 1.1 Type of organization (corporation, partnership, etc.): COR.pOQ Pr'Tt ONI <br />].2 LRS. Tax I.D. No. or Social Security Number: KH - D y g y 3 $L7 <br />2. Operation name (ok. mine or sRe name}: ~TCIi~(t ` VRI.E P [T <br />3. Permitted acreage (new or evstmo_ site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(sl to be mined: ~[ ~ ~ + 6 R~1~L <br />5.1 Incidental commoditie(s) to be mined: 1. Ibs/Tons/vr <br />3. / Ibs/foas/vr 4. / lbs/I'ons/vr <br />r>?J~.-~ permirted acres <br />acres <br />,ZS.3 acre; <br />$2 344. application fee <br />$2.906.00 quazry application <br />$1.938.00 amendmcntfee <br />$2,344.00 conversion Fee <br />2. ! Ibs/Tons/vr <br />5. ! 1bslToas/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: ~' N ST/~UL~TIOA~ s!'L9'TF.~P~'A L <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />