Laserfiche WebLink
. <br />Michael B, Long <br />CHECK ONE: There is a File Number Already Assigned to this Operation Division Director <br />Permit # M -oZlDI-,LQ~-, (Please reference the file number currently assigned to this operation) <br />New Application (Rule ].4.5) _ Amendment Application (Rule 1.10) <br />Conversion Application (Rule I.I I) <br />Permit # M - -_ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Limited Impact (I 10) Operation Reclamation Permit contains three major parts: (1) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by <br />the Office, and outlined in Rules b.l, 6.2, 6.3, 6.5, and 1.6.2(])(b); and (3) the application fee. When you submit your application, be sure <br />to include one (l) complete siened and notarized IVORY ORIGINAL and one (1) copy of the completed Ivorv application form, two (2) <br />copies of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check <br />for the application fee described under (4) below. Exhibits should NOT be bound o[ in a 3-ring binde[; maps should be folded to 8 1/2" <br />X 1 I" or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ~,C Ate. <br />Department of Natural Resources ~C'°' ~; - T! ~~ <br />YY.~ L,. - <br />1313 Sherman SL, Room 215 ~ ,.,-~~ REC~'~t °' D I v 15 l O N o <br />Denver, Colorado 80203 ter, !+ ~ ~~+ <br />Phone: 1303) a66-3567 ~~ C~~ •• p ~ n~~Q~ M I N E RA L <br />rAx:t3o31ar_-slob ~ .~ ,andGenlo9Y ~~d „ ~ & <br />• app CONSTR[1,~+T}dN MATERIALS G E O L O G <br />©IVtSta° RECLAMATIOt <br />>,tsion of Minerals and Geo a Yf't I N I N c• s A F E r <br />LIMITED IMPACT (110) OPERATIC <br />- ` RECI;AMATION PERbIIT APPLICATION FORM Bill Osvens <br />Governor <br />Greg F. Walther <br />Execmive Dircaor <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information described below.. <br />2. <br />3. <br />~c 1Hblol <br />Applicant operator or company name (name to be used on permi0: A~amaS~l ~~ <br />1.1 Type of organization (corporation, partnership, etc.): COUn/7y ~OVE/PN/19C~n1 T <br />1.2 LR.S. Tax ID No. or Social Security Number. 2.: S y- ~ t~ob ') a ~ <br />Operation name (pit, mine or site name : A ~/4N'IU SA CJN ~ ~/ ~~ •~ /y4 ~ -2 ,~Q <br />Permitted acreaee (new or existine site): <br />permitted acres <br />3.1 Change in acreage (+) <br />Tofal Acreage in Permit Area <br />4. Fees: <br />4.1 New Application: <br />Amendment Fee (C.R.S. 34-32.5-125(II)): <br />4.2 Conversion Fee (from I IOd to 110 875.00 conversion fee (Rule 1.11.2(2)) <br />5. Primary commoditie(s) to be mined: 6rPAU6L SAnl7 <br />acres <br />99- acres <br />1094.00 application fee <br />$719.00 application fee <br />5.1 Incidental commoditie(s) to be mined: 1. / Ibs/I'ons/vr 2. / Ibs/i'ons/yr 3. / Ibs/fons/yr <br />4. / Ibs/I'ons/vr 5. / Ibs/fons/vr <br />51 Anticipated end use of primary commoditie(s) to be mined: ~il~ A)ATER)!)L/ J?pgDt Ij/JSC~SP/~/9~rlj~~k <br />J <br />Anticipated end use ofincidental commoditie(s) to be mined: <br />