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II IIIIIIIIIIIIIIII <br />999 <br />STATE OF COLORA~ J <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources , <br />131 3 Sherman St.. Room 21 i ~ :,' <br />Denver. Colorado 80203 ' <br />Phone: (3031 8663567 CONSTRUCTION MATERIALS _ '~ _ ~~;`, <br />FAX: (303) 8728106 REGULAR (112) OPERATION <br />r !no'. <br />RECLAMATION PERMIT APPLICATION FORM "'" ~ <br />7 pll•,i:'~ ~ '' <br />CE{ECK ONE: ~ There u a File Number Alreadv Assigned to this Operation <br />Permit # M -gL- 2 7 5_ (Please reference the file number cmreutty assigped to this operation) <br />New Application (Rule 1.4.5) <br />Conversion Application (Rule 1.11) <br />Amendment Application (Rule I.10) <br />Pertnit # M -_ - (provide for Amendments and Conversions of existing permits) <br />~~ <br />DIVISION U <br />MINERAL' <br />GEOLOGY <br />0. ECLAMATIO `~ <br />MINING•SAFET- <br />Bill Owens <br />fiovernar <br />Greg E. Watcher <br />Execwwe D~reaor <br />Michael 8. Lonc <br />Divnron Director <br />The apphcation for a Constrttction Materials Regalar I l2 Operation Reclamation Permit contains three major pmts: (1) the application form: <br />(2) Exhibits A-S, Addendum I, aw sections of Exhibit 6.5 (Geoteclmical S[abihry Exhibit: and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete sired and notarized IVORY ORIGINAL and four (4) copies of the completed von <br />application form, £rve (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geatechnical Stability Exhibit. and a check for <br />the apphcation fee described under Section (4) below. Exlibits should NOT be bound or in a 3-ring binder, maps should be folded to <br />8 I/2" 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 />GENERAL OPERATION INFORMATTON <br />Type or print clearly, in the space provided, aU information described below. <br />AooGcanUooerator or comoaovname (name to be used on permit <br />Diana K. Watson <br />I .l Type of organization (corporation parmerslip, etc.): i n d i v i d u a l <br />1.2 I.1LS.Taxi.D.No.orSocialSecuritvNumber: R4-1581666 <br />2. ODeration name (nit, mine or site Hamel: Stout -Ati c k P i t <br />3. Permitted acrca¢e (new or eiistin¢ site): 4 2 • 8 permitted acres <br />3.1 Change in acreage (+) acres <br />3.2 Total acreage in Permit area 4 2 • 8 acres <br />4. Fees <br />4.l New Application $2.344.00 application fee <br />4.2 New Quarry Application $2.906.00 quam application <br />4.4 Amendment Fee $1.938.00 amendmrnt fee <br />4.5 Conversion to 112 operation (set by statute) $2.344.00 conversion fee <br />5. Ptimarvcommoditie(s)tobemined: GRAVEL SAND <br />5.1 Incidental commoditie(s) to be mined: 1. / Ibs/fons/yr 2. / Ibs/fons/vr 3. / Ibs(fooshT <br /> 4. / Ibs/fooshT 5. / Ibslloos/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Genera 1 c o n s t r u c t i o n <br />5.3 Anticipated end use of incidental commoditie(s) [o be mined: <br />