PERMFILE57538

• Permit No: M2004001
• IBM Index Class Name: Permit File
• Doc Date: 1/5/2004
• Doc Name: Application
• From: Lincoln County
• To: DMG
• Media Type: D
• Archive: No

M-2004 - 001 '~
STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
DeQartment of Natural Resources
7 37 3 Sherman St., Room 215
Denver, Colorado 80203 n t v t s t O N o e
Phone: [phone] MINERAL S
FAX[[: (303) 832-Bto6 CONSTRUCTION MATERIALS R~C~ii/E G E O L O G Y
I~ I L E C ®~ Y LIMITED IlIIPACT (110) OPERATION C~ R E C L A M A T I O N
/"OD ~1~1~w/A/,~~ JAN 0 51004 INING•SA FETY
r n J 4 ~Y,Y CLAMATION PERMiT APPLICATION FORM
Bill Owens
Division of Minerals and Geolp$yemor
CI~CIi ~~~:
There is a Frye Number Already Asaigaed to this Operation
Greg E. Walther
Ezeculive Director
Ronald W. Cattany
Permit # M -_ _ _ (Please reference the file number currently assigned to this operation) Acting Division Director
_~ New Application (Rule 1.4.5)
Amendment Application (Rule 1.10)
Conversion Application (Rule 1.11)
Permit # M -_ (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Limited Jmpact (110) Operation Reclamation Permit contains three major parts: (1) the
application form; (2} Exhtbits A-J, Exhrbit L, Addendmn 1, any secfions of Exhibit 6.5 and Geotechnical Stability Exhrbit, as required by the
Office, and outlined in Rnles 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When yon submit your application, be sure to
include one (1) complete sinned and notarized IV ORY ORIGINAL and one (I) copy of the completed Ivor application form, two (2) copies
of Exhibits A-J, Exhrbit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhrbit), as required, and a check for the
applicarion fee_descrilred ands j4~below. Exhibitsshould NOT be bouad.or ia-a 3-dng binder; Wraps sheuld be felded tcrR 1/2" X 11" or
8 1/2" X 14" size. To expedite processing, please provide the information in the format and order descrbed in tbis form.
GENERAL OPERATION INFORMATION
Type or prime clearly, in the apace provided, ALL information described below.
1. AonlicanUoueratororcomnanvname(nametobeusedonoermit): Lincoln Count
1.1 Type ofarganizatioa(corporation,partnership,etc.): Government
1.2 I.RS. Tax ID No. or Social Sectnity Number: 2.:
2. Operation name (nit, mine or site name): Lo f d ah 1
3.. Permitted acreage (new or eriatme site): +or - 9 . 6 permitted acres
3.1 Change in acreage (+) a~eS
3.2 Total Acreage in Permit Area acres
4. Fees:
4.1 New Application: $1.094.00 application fee
Amendment Fee(C.RS.34-32.5-125(11)): $719.00 application fee
4.2 Conversion Fee (fmm 110d to 110 875.00 conversion fee (Rule 1.11.2(2))
5. Primary commoditie(s) to be mined: Rand (; r a vP t
5.1 Incidental commoditie(s) to be mined: 1. NA/ ]bs{I'ons/vr 2. / 1bs~Tons/vr 3. / Ibs/Tons/vr
4. / lbs/T'ons/vr 5. / Ibs/Tons/vr
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: