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/YI-o7ooy-0~7 <br />REC~Ei ~ =_ <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE T There Is a File Number Already Assigned ro thD Opentlon <br />t/ OCT 2 ~ 2004 <br />Division al M19iooi... ~ `~~ <br />Permu # t~v -,~!_ , (Please reference the file number currently assigned to this operation) <br />_~ New Appbphon (Rule 1 4 5) ~ Amendment Application (Rule 1.10) <br />_ Comerslon Application (Rule t I q <br />Permit # _~•_; ~ ~ (provide for Arnendmmts and Conversions of existing parmits) <br />The application for a Construction Ma[errals Regulaz 112 Opcretion Reclamation Permit contains three major parts (p [he application <br />fortn,(2)Ezhtbns A-S, Addendum 1, any sections ofExhtbu 6.5(Geotechnrcal Stability Exlabit, and (3)the applicahon fee. When you <br />suborn your application, be sure to include one (1) ~pptpis3e si and notarized OR]GINAL and one (1) wpy of the compkted <br />application form, two (2) copses of EzhtbRS A-S, Addertdtun I, appmpnate sections of6.5 (Gootechnical Stability Fxhibit, and a check for <br />[he apphoznon fee described under Section (4) below Exhibits shook N4T be bound or in a 3-ring border, maps should be folded ro <br />8 !/2" X l l" a 8 l2" % l4" sim. To expedite processing, please provide the information i¢ the format and order desrnbed m this form <br />GENERAL OPERATION ]NFORMATiON <br />Type or print clearly, la the space proWded, ~ Intormatior requested below. <br />I Aonlicantlonerator or comosnv name (name [g ~f stied on cermltl: Clear Creek District Water PfOVIderS. LLC "~ <br />II Type oforganrzation (wrporation, pitrtnership, etc.): Limited Liability Corporation <br />1 Z I R.S Tax 1 D No or Social Secunry Number' 90-ldgq'igq <br />2. OoeraHon name loft. mine or site namel: MMRR Qtl2rry / <br />3 f~nttitted acresee (new or esNHne site) 526.70 permitted saes <br />l I Change m acreage (+) aces <br />3 2 Total aaeage m Permit area ~?6. 70 acres <br />4 ~1g2. <br />4 I New Application 52.344 00 application fee <br />~2 New Quarry Application 52.906.00 quarry aPPhcahon <br />4 4 Amendment Fee S 1 9 800 amendment fee <br />4 5 Conversion to I ! 2 operation (set by statute) ,-,~3a4 00 conversion fee <br />5 PAmerv commod Hels) to he mined: SD@CiflCBtlOft COrIStrUCIl01l AOQfegBtP,S <br />5 1 Incidental comriodine(s) to be mined: ! NIA Ibs/Tonsrvr 2 ! Ibs?onslvr <br />3 I Ibs?onahr 4 / Ibs?onslvr 5. / IbslTons/vr <br />5.2 Amticipated and use of primary Commoditie(s) to be mined: ("igtlStRlCtlOrt AgOfeg2teS (211 tVDeS) <br />5 3 Anticipated end use of incidental commoditie(s) to be mirod. N/A <br />Exhibit 82 <br />