PERMFILE65943

• Permit No: M1999077
• IBM Index Class Name: Permit File
• Doc Date: 7/12/1999
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

i
STATE, OF COLOR~.DO
DIVISION OF MINERALS AND GEOLOGY
Depanmem of Natural Resources
Ill 3 Sherman SI., Room 215
Denvcr, Colorado 80203
Phnnc;(301)8(a6-3567
FA!(; (3031 832- 6
~~ ~~ CONSTRIICTION *~'I'~RTATS
n~~~'/V, 1 REGQLAR (112) OPERATION
~~ f(-y`,/X~~r''~ ~~~ RECLAFF.TION PERt~IIT APPLICATION FORM
tl ~i
CHECK ONE: ** New Application (Rule 1.9.5) _
Conversion Application (Rule 1.11)
DEPARTMEN-i- OF
NATURAL
RESOURCES
Roy Rosner
Govempr
~ame~ 5. Lxhhead
Executise Dirtror
dLChael B. Long
Didsion Duecwr
Amendment Application (Rule 1.10)
Permit # - -_ (provide for Amendments and Conversions of existing
permits)
The application for a Construction Materials Regular 112 Operation Reclamation Permit contains
three major parts: (1) the application form; (2} Exhibits A-S, Addendum 1, any sections of
Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your
application, be sure to include one (1) complete sinned and notarized IVORY ORIGBU~L and four (4)
copies of the completed Ivor application form, five (5) copies of Exhibits A-S, Addendum 1,
appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application fee
described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps
should be folded to 8 1/2" X 11" or 8 1/2" X 19" size. To expedite processing, please provide
the information in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or priest clearly, in the space provided, ALL information
requested below.
1- AHHlicant/oaerator or camHanv name (name to be used on Hermit):
1"ontezuma Countv
1.1 Type of organization (corporation, partnership, etc.): county eovernment
1.2 I.R.S- Tax I.D. No. or Social Security Number: 84-60007 86
2. Operat ion name (Hit, mine or site name): Ormiston Gravel Pit
3. Permitted acreage (new or existino site): ±28 permitted acres
3.1 Change in acreage (+) acres
3.2 Total acreage in Permit area *_28 acres
9- Fees:
4.1 New Application 51 ,675.00 application fee
4.2 New Quarry Application 52,32 5-00 quarry application
4.3 Milling Application (Non-DM0) 53.100-00 milling application
9-9 Amendment Fee 51,550.00 amendment fee
4.5 Conversion to 112 operation (set by statute) 5 1,875.00 conversion fee
5. Pr~>"a ~ commoditie(s) to be mined: gravel aQQre>Ya teS
5.1 Incidental commoditie(s) to be mined: 1- lbs/Tons/vr
2. / lbs/Tons/vr 3. / lbs/Tons/vr
4- / lbs/Tons/vr 5. / lbslTonslvr
5.2 Anticipated end use of primary commoditie(s) to be mined• road ConstruCtiOn
5.3 Anticipated end use of incidental commoditie(s) to be min ed: