PERMFILE53502

• Permit No: M2005044
• IBM Index Class Name: PERMIT FILE
• Doc Date: 7/14/2005
• Doc Name: limited impact operation
• From: lincoln county
• To: dmg
• Email Name: MAC
• Media Type: d
• Archive: No

STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
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Department of Natural Resources
1313 Sherman SL, Room 215 //ff C[
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O C O L D RA D O
DIVISION O F
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Phone: (303) 86tr3567 CONSTRUCTION MATERIALS MIN &RA L 5
FAX: [phone] pivision of fAinerd ; @~ itaalsry
TIED IMPACT
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OPERATION
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G E O L O G Y
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~ 0.ECLAMATION•MINING
SAFETY•SCIENCE
RECLAMATION PERMTI APPLICATION FORM
Bill Owens
Governor

CHECK ONE: There is a File Number Already Assigned to this Operation Greg E. Walther
Executive Director
Permit # l~if -_ _ _ (Please reference the file number currently assigned [o this operation) Ronald w. catrany
Division Director
X New Application (Rule ].4.5) Amendment Application (Rule 1.10) Natural Resource Trustee
Conversion Application (Rule 1.11)
Permit # M -, -_ (provide for Amendments and Conversions of existing pemtits)
The application fora ConstructionMateria]sLimitedlmpact(110)OperationRec]amationPerntitamtainsthreemajorparts: (1)theapplication
form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required 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) comalete signed and notarized IVORY ORIGINAL and one (I) copy of the completed Ivon~ application form, two (2) copies of Exhibits
A-.f, Exhibit L, Addenduun I, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the application fee
described under (4) below. Exhibits should Q be bound or in a 3-ring binder; maps should be folded to 8 I /2" X l l" or 81 /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 bellow.
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1. AaolicanUocerator or rnmnanv name (name to be used on permit): Lincoln C o u tit y
].l Type of organization (corporation,pattrrership,etc.): Government
1.2 1.2 I.R.S. Tax ID No. or Social Security Number:
2. Operation name (nit, mine or site Hamel: Hoffman P i t
3. Permitted acrea¢e (new or eiist[n¢ site): 9 . 9 permitted acres
3.1 Change in acreage (+) acres
3.2 Total Acreage in Permit Area 9 • 9 acres
4. Fees:
4.1 New Application: $I 094.0(1 application fee
Amendment Fee(C.R.S.34-32.5-125(II)): $719.00 application fee
4.2 Conversion Fee (from I lOd to 110 $875.00 conversion fee (Rule 1.11.2(2))
~. Primary commoditie(s) to be mined: Sand f; r a va 1
5.1 Incidental commoditie(s) to be mined: I. NA/ Ibs/Tons/vr 2. / IbsJTons{yr 3. _ / Ibs~I'ons/vr
4. / Ibs/Tons/yr ~. / 1bs/Tonshr
5.2 Anticipated end use of primary commoditie(s) to be mined: Road M a i n t e n a n c e
Anticipated end use of incidental commoditie(s) to be mined: NA
Office of Office of Colorado
Mined Land Reclamation Active and Inactive Mines Geological Survey