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• <br />STRTE OF COLO[tADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Dcpanmem of N,uunl Heenurces <br />171.1 Sherman 51.. Roum ? 15 <br />Denver, Culur,tdo HUlU3 <br />Phune: (JU7106G-3.567 <br />FAX: 13031 83'_-71106 <br />CONSTRUCTION MATERIALS <br />~~ <br />DIVISION O <br />M[NERAL <br />REC~~~~~ G E O L O G <br />0.EC LAM ATIOr <br />MININ G'SA FET' <br />REGULAR (112) OPERATION MAR 1 p 2000 <br />RECLAMATION PERMIT APPLICATION FORM B~II Owens <br />Inerats &Geolo9Ycovernnr <br />pivislcn at M ereg E. wmcner <br />Executive Direnor <br />CHECK ONE: ~ New A licazion Rule 1.4.5) _ Amendment A lication Rule 1.10(.1 chael B. tonx <br />PP ( PP ( Division Director <br />Conversion Application (Rule 1.11) <br />Permit ri M -_ _ (provide for Amendments and Conversions of existing permits) <br />The application for a Cottswction Mazerials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Extubia A-S, Addendton 1, any sections of Exhiba 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be slue to include one (I) complete sieved and notarized IVORY ORIGINAL and four (4) copies of the completed [vorv <br />application forth, live (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geo[echnical 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 1!:" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION [NFORMATION <br />Type ar print clearly, in the space provided, ~ information requested below. <br />I. AoolinoUooerator or comoaov Dame (name to be used o0 permit): M•A~ ~~~~~ C.ot`lS"TI2L,.lG1'I Old <br />I.l Type of organization (corporarion, partnership, etc.): GOR PD p.•A~ (Ohl <br />I? I.RS. Tax I.D. No. or Social Security Number: 89•- [~87ro9 ~ <br />2. Operation name (nit, mine or site name): ~/IonlUw~evr~ Vf ew ~rfFVe/ ~/T <br />3. Permitted acreaee (eew or existiotr 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 />4.3 Milling Application (Non-DMO) <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: $,4ND G(Z,4VEl_ <br />5.1 Incidental commoditie(s) to be mined: I. N Ib- Ibslions/vr <br />3. / Ibs/fons/vr 4. / Ibs/Tons/vr <br />37•~ permitted acres <br />acres <br />3~•~o acres <br />51.875.00 application fee <br /> quarry application <br />53.100.00 milling application <br />51,550.00 amendment fee <br />51.875.00 conversion fee <br />~ / Ibs(fons/vr <br />5. / Ibs~I'onsivr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: C.Df.I$TPJA~TIdN Mb7F; -1.! AC•S <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />