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,. Poch (66Ys <br /> III IIIIIIIIIIIIIIII i 4 * 1-7Uq� <br /> b IA YE O'- COLORADO <br /> • DIVISION Of MINERALS AND GEOLOGY <br /> of <br /> Department of Natural Resources <br /> 1313 Sherman 51.. Room 215 RECEIVED 7"7 <br /> Denver,Colorado 80203 <br /> Phone:(303)866-3567 �ppry� 9 �ggg <br /> FAX (303{$32-8106 i 1H1V <br /> �. DEPARTMENT OF <br /> r���� „ DiIS�'ei'tdinets&Geology „ iNLATUI7RALL <br /> CONSTRUCTION MATERIALS 1�%S�V�CI%S <br /> REGULAR (112) OPERATION Roy Romer <br /> L�u�ro RECLAMATION PERMIT APPLICATION FORM Governor <br /> \\� <br /> q�. James S.Lochhead <br /> p(� E.ecurive Director <br /> O\,�S Michael B.Long <br /> Division Director <br /> CHECK ONE: _X New Application (Rule 1.4 .5) Amendment Application (Rule 1.10) <br /> Conyv�e�rsio�R(A plication (Rule 1.11) <br /> Permit # 1 v \ - l� - -_ (provide for Amendments and Conversions of <br /> existing permits) <br /> The application for a Construction Materials Regular 112 Operation Reclamation Permit contains <br /> three major parts : (1) the application form; (2) Exhibits A-S, Addendum 1, any sections of <br /> Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br /> application, be sure to include one (1) complete signed and notarized IVORY ORIGINAL and four (4) <br /> copies of the completed Ivory application form, five (5) copies of Exhibits A-S, Addendum 1, <br /> appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application fee <br /> described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps <br /> should be folded to 8 1/2" X 11" or 8 1/21' X 14" size. To expedite processing, please provide <br /> the information in the format and order described in this form. <br /> ---_____ <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly, in the space provided, ALL information requested below. <br /> --------------------------------------------------------------------------------------------- <br /> 1. Applicant/operator or company name (name to be used on permi.t) - <br /> CAMAS rnlnrado. Inr_ <br /> 1.1 Type of organization (corporation, partnership, etc. ) : An Indiana Corporation <br /> 1.2 I.R.S. Tax I.D. No. or Social security Number: 04-040340 <br /> 2. Operation name (pit, mine or site name) : Cooley Reservoir and fulton Wildlife Area <br /> 3 . Permitted acreage (new or existing site) : -74q• permitted acres <br /> 3.1 Change in acreage (+ or -) - _ acres <br /> 3.2 Total acreage in Permit area . 349 acres <br /> 4. Fees: <br /> 4.1 New Application $1,875.00 application fee <br /> 4.2 New Quarry Application $2,325.00 quarry application <br /> 4.3 Milling Application (Non-DMO) $3,100.00 milling application <br /> 4.4 Amendment Fee $1,550.00 amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) $1,875.00 conversion fee <br /> 5. Primary commoditie(s) to be mined: Sand Gravel <br /> 5.1 Incidental commoditite(s) to be mined: 1. Overhurder17300,000 )D�G/Tons/yr <br /> 2. Gold / 12 lbs/T&Wyr 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: Asphalt S Concrete Production <br /> 5.3 Anticipated end use of incidental commoditie(s) to be mined: <br /> Overburden - Onsite reclamation/Offsite clean fill 5. Borrow material <br /> Gold - Sales to specialized Contractor <br />