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/Su,bmt~~I o-~ Add~+~unG( ~~~~als fog- IIZf,A~~1~c~tfio~ <br />STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY ~~ <br />° <br />' t ~ ~ ~ ~~~a <br />Department of Natural Resources r'" <br />'. <br />~\ <br />t` G ~ <br />13t35herman St., ROom 275 <br />Dom, cateado solos ~ ~SC~M,~ <br />e S / , ' <br />~ I i ~ A ~ ~ ~ii~~ <br />Phoce: (303) 866-3567 CONSTRUCTION MATERIALS }"~ <br />~ 'lit <br />FAX: 4303) 832-8706 REGULAR (112} OPERATION ~i~'~ls:. ;a ' e;;;~ <br />1~ <br /> RECLAMATION PERMIT APPLICATION FORM ;; ~, <br />COLORADO <br />p 1 Y 1$ I D N O F <br />MINING <br />SAFETY <br />- ~~lP - ~ (7~'~ aili awns <br />Governor <br />BECK ONE: There is a File Number Already Assigned to this Operation Russeu George <br />Permit # ~-_ _ ~ (Please reference the file number currently assigned to this operatlb'R~"'e Di"e`Q" <br />New A lication Rule 1.4.5 Amendment A lication Rule 1.10 Ronald w. Caltany <br />PP ( ) PP ( ) Division Director <br />_ Conversion Application (Rule l . l 1) Natural Resource trustre <br />Permi[ # M -_ -~ (provide for Amendtt~nts and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application <br />forrn; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geo[echnical Stability Exhibit; and (3) the application fce. When you <br />submit your application, be sure to include one (I) complete signed and ~tarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotecht7ical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to <br />8 1 {2" X 11 " or 8 172" X I4" size. To expedite processing, please provide the information vt the format and order described in this form <br />GENERAL OPERATION INFORMATION <br />Type or print elearly, ip the space provided, ALL inrormation requested bebw. <br />Applicapt/operator or comoanv name (nattce to be used on cermit): ~OVeland Ready Mix Concrete, Ina `-- <br />Ll Type oforganization (cotpotation, partnership, etc.):. Corporation <br />2. Otrerafion name foil. wipe or site name]: BOkelman-Walters <br />3. Permitted acreage (new or eaistina site): 2~1 pemmtted acres <br />3.1 Chapge in acreage (+) acres <br />3.2 Total acreage in Pertnit area <br />4. <br />4.1 New Application <br />4.2 New Quarty Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute} <br />5. Primary commoditie(s) to be mined: Sand gravel <br />S.I Incidental corruttoditie(s) to be milted: 1. N/A _ lbsPConsivr <br />3. / Ibs/Tons/yr 4. / lbs/fonslyr <br />52 Anticipated end use of primary commoditie(s) to be mined: COnStI'UCtIOn <br />5.3 Anticipated end use of incidental convr7oditie(s) fo be mined: N/A <br />l . <br />Office of <br />Mined Land Reclamation <br />201 acres <br />$2.344.00 application fee <br />52.906.00 quarry application <br />$1.938.110 amendment fee <br />$2.344.00 coltversion fee <br />2. ! Ibsflons/vr <br />5. Ibs/TonsJvr <br />ice of <br />ACiive and Inactive Mines <br />