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1i( -~~.~ - o ~ y <br />/ ~~A~~@~~I'ATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY /'~ ~~ <br />"LLL Department of Natural Resources <br />1313 Sherman St., Room 215 Division of Minerals and Geology <br />Denver, Colorado 80203 <br />Phone: (3031866-3567 CONSTRUCTION MATERIALS <br />FAX: (303)832-8106 ~~~~ ~~ <br />LIhITTED IMPACT (110) OPERATIOI~~ ~ ~~~ <br />RECLAMATION PERMIT APPLICATIONI FORMyf <br />DIVISION O! <br />MINERAL) <br />GEOLOGY <br />EC LAMATION <br />. INING•SA FETY <br />Bill Owens <br />Governor <br />Greg E. Walther <br />CHECK ONE: There is a File Number Alere~ad sig/n~ed (tip this Operation Executive Director <br />~,/y~ p`ZO~~-t1~_/ Michael g. Long <br />Permit # ~ 1([Please reference Ih222 Ille number cuaently assi~ed to this operation) Division Direttor <br />~_ New Application (Rule- M4.5) _ Amendment Application (Rule 1.10) <br />Conversion Appbcation (Rule 1.11) <br />Permit # ~-, (provide for Amendment and Conversions of existing permits) <br />The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the <br />Office, and omlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When yon submit yon apphcation, be sure to <br />include one (1) comolele sued aad notarized IVORY ORIGINAL aad one (1) cL~y of the completed ITS application form, two (2) copies <br />of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the <br />application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring binder, maps should be folded to 8 1/2" X 11" or <br />8 12" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the apace provided, ALL information described bebw. <br />lsaca County <br />1.1 Type of organization (corporation, partnership, etc.): G o v e rme n t a l Entity <br />1.2 LRS. Tax ID No. or Social Security Nmnber: 2.: R ~ - F n (t n 7 4 4 <br />2. Ooerationname(oit.mineorsitenamel: Re-JAer, gravel pit #18 Fipe springs KuncY. LLC <br />3. Permitted acrcaee (eew or eaistise akel: ~; _ 4 permitted acres <br />3.1 Cltaage in acreage (+) I ~ acres <br />Tota(Acreage in Permit Area ~ . 4 acres <br />4. Fees: <br />4.1 New Application: $1,094.00 appficationfee <br />Amendmeat Fee (C.R.S. 34-32.5-125(II)): $719.00 application fee <br />4.2 Conversion Fee (from I lOd to 110 875.00 conversion fee (Rule 1.11.2(2)) <br />~. Primary mmmoditie(sl to be mined: Grave 1 S ~. nd <br />5.1 Incidental commoditie(s) to be mined: 1. n % ~ Ibs/Tons/vr 2. ri / a: Ibs/Tons/vr 3. / lbs/Tons/vr <br />4. / lbs/fons/vr 5. / Ibs/fons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: until a r a ve l i s deplete d <br />Anticipated end use of incidental commoditie(s) to be mined: <br />