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TATE OF <br />DIVISbN OF MINERALS AND GEOLOGY <br />Deparanem d IVaaeral Reforaaes ~ ® A `, <br />13135hennan SL, Roan 215 RE~~,C p! ~D <br />~`"M°!' ~0~0 eo2o3 CONSTRDCTION MATEBIAL4 <br />"'°rl; `303 e(,633a7 REGULAR (112) OP&RATiON / APR 1 3 2004 <br />~;Y RECLAMATION PERMrr APPLICATION FORM <br />®~ ~~e~lINSS'SN~ GivisionofMinerals&Geolag <br />CHECK ONB: SAU/Theme b a Fik Nam6er,AlrcsdY AaigoM to t66 Operation <br />Permit M ~- ~~~-~~p(PI/ e~erefaeme the 5le mrmber uvrtmtty assi~od to this opamian) <br />1CX_ Ntar Applmatim (Role 1.4.5) _ Am®dtamt Applicatim (Ruk 2.10) <br />_ Ceavenlaa Application (Rule I.I I ) <br />Permit 8 ~•-^•_ _ (pmvide far Ameodmenb and Coaresban of existing permits) <br />EOLOG <br />fAlfTT•rC1eNC! <br />&II Ownu <br />Gorerror <br />ores E. Waldaa <br />E>~eNhe anen <br />Rawer w. omnr <br />Olvbian ollaeor <br />Nauw ResaNO7nNae <br />TheapplicalionforaCeostrtrrtimMeterielsRegulm 112 Operation Reclamation Petmitcaoteirethroemajorpasts:(I)theapplicetionfosm; <br />(2) Exhibits A-S, Addendum 1, arty sectiaas ofF.xhrbit t5.5 (Oeotar]urical Stability Exhibit and (3) the application fa. When you submityaa <br />application,besureWiailudoone(1)~gWlraeai®edendtiVOR>1'OBiGINA! anderne(1)oopydtbeoanpietedl~applirmtioa <br />farm, two (2) copies ofFxbbitaA-S, Addmdmn 1, epptopriate sactimv x'6.5 (Oeical SmhilityExln'bit. and n clraclc far the applirxtian <br />fcedetcaibedu~erSeotiaa(4)below. Ekbtbilsshoutdtj,QZbebamdarina3-ringbiorkr;mepsaharWbefoldedto81f2`X(1"a812"X <br />14" size. To expedioe prooeeaing, please provide the iafasmetion in the format and order desaibedm this farm. <br />GENERAL OPERATION INFORMATION <br />~'Pe ~ P~ dam!! M ~ +P~ Pf'm'~+ALL laktaatioa regaeabed 6ebw. <br />1. SpnReaatlaeerator or esfnoaev Dame (ease to be aced an err. LEONE SAND and GRAVEL, LLC ~ <br />1.1 Typeafagmizetion(catpatatian,pettnerahip,etcJ: _LIMITEDLIABILITYCOMPANY <br />1.2 I.R.S. Tex ID. Na or Social Seaairy Number: <br />2. Oneratim name (alt. uhfe er ebe oaeel: <br />3. PeanMbed acama (eaw err esM~a ebel: <br />3.1 Change in arreage (+) <br />3.2 Total ataeage in Permit area <br />LEONE GRAVEL PIT <br />4. ~: <br />4.1 New Application <br />4.2 New QTY Application <br />4.4 Aiaes>dinent Fee <br />4.5 Conversioe to 112 operation (set by stance) <br />5. Psimarv eomafoditidil to be Bleed: SAND <br />68.0 P~~ saes <br />a~ <br />66.0 a~ <br />application fee <br />9a~' appGcatiw <br />Sl_938.00 ame~imtfa <br />X44.00 conversion fx <br />GRAVEL CONSTRUCTION AGGREGATEB ROAD BASE/STRUCT.FILL <br />5.1 Incidental commoditie(s) W be miced: I. N/A Ibs/faos/vr 2. N/A -bs/faos/vr <br />3. N/A Ibs/foav/vr 4. A(A Ibs/foas/vr 5. N/A R~s/1'onsPor <br />5.2 AnticipaLCd end use of priurary mmnroditie(s) to be mined: CONCRETE /ASPHALT AGGREGATES, and ROAD BASE <br />5.3 Anticipated and uae of iticideatal cormoditie(s) to be mined: NONE <br />Hof OfRoe of Cebrdo <br />Mhad ~rld ~ AdNa and Irfaeave Mines Geobglcal Survey <br />