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II IIIIIIIIIIIII III ! <br />STATE OF COLORADO <br />• DIVISION OF MINERALS AND GEOLOGY <br />Depanmem of Natural Resources <br />1313 Sherman 51.. Room 27 5 <br />Denver, Colorado 80203 <br />Phone: (3031 866-3567 <br />FAX: (3031 872-8106 <br />~" ~ ~ <br />RREGI~ rlsR~aTZON R lAi2> RECEIVED <br />ATION PBRMIT APPLICATION FORM <br />~~~~I~ <br />DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />Roy Romer <br />Governor <br />`fjUf- 2 ~ 1998 lames S. Lochhead <br />Executive Director <br />Division of Minerals & Geologo;V sio~ o,:e .or <br />CHECK ONE: X NeN Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # - -_ (provide for Amendments and Conversions of <br />existing permits) <br />The application for a Regular 112 Operation Reclamation Permit contains three major parts: (1) <br />the application form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical <br />Stability Exhibit; and (3) the application fee. When you submit your application, be sure to <br />include one (1) complete signed and notarized IVORY ORIGINAL and four (4) copies of the completed <br />ivory application form, five (5) copies of Exhibits A-5, Addendum 1, appropriate sections of 6.5 <br />(Geotechnical Stability Exhibit, and a check for the application fee described under Section (4) <br />~ow. Exhibits should not be bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" <br />8 1/2" X 14" size. To expedite processing, please provide the i forma ion in the format and <br />order described in this form. <br />_________________________________________________________________ _~___s~~ ~S4 !8 7~S~CX~ <br />GENERAL OPERATION INFORMATION ~~~- ~~ <br />Type or print clearly in the space provided the information requested below. <br />1. Applicant/operator or company name (name to be used on permit): <br /> 1.1 Type of organization (corporation, partnership, etc.): corporation <br /> 1.2 I.R.S. Tax 2.D. No. or Social Security Number: <br />2. Operation name (pit, mine or site name): Patton Clay Mine <br />3. Permitted acreage (new or existing site) 280 permitted acres <br /> 3.1 Change in acreage (+ or -) -0- acres <br /> 3.2 Total acreage in Permit area 280 acres <br />4. Fees• <br /> 4.1 New Application 1 875.00 application fe <br /> 4.2 New Quarry Application 52,325. quarry app ication <br /> 4.3 Milling Application (Non-DMO) 53,100.00 milling application <br /> 4.4 Amendment Fee 51,550.00 amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) 51,500.00 conversion fee <br />5. Primary commod it ie(sl to be mined: Clay <br /> 5.1 Incidental commoditie(s) to be mined: 1{(Otk Pr nriirr-Fc 75(1!1 l~s/TOn9/vr <br /> 2. / lbs/Tons/yr 3. / lbs/Tons/vr <br />• 4. / lbs/Tons/vr 5. / lbs/Tons/vr <br /> 5.2 Anticipated end use of primary commoditie(s) to be mined: Brick manufacture <br /> 5.3 Anticipated end use of incidental commoditie(s) to be mined~Onctrnrtinn Aq~ra~ata <br />