PERMFILE69814

• Permit No: M2000014
• IBM Index Class Name: Permit File
• Doc Date: 1/27/2000
• Doc Name: 110 Application form
• Media Type: D
• Archive: No

~ iii iiiiiiiiiiiii iii
ST1~TE
DIVISION OF MINERALS AND GEOLOGIY
Uepanmenl of Natural Resources
1 ] 13 Sherman $I„ Room 215
Denver, Colorado 80203
Phone [phone]~356i
FAY. 1703) 832-810n
• ~ ~" g 757=
OF ~OLORAO ~
REc%CI vED
JAN ^ ~ 2000'
Divis:;.. ,,, ,r.., n=~..~s a Glli11~
CONSTRUCTION MATERIALS
D I V I S I O N O F
MINERALS
6t
GEOLOGY
RECLAMATION
MINING•SAEETY
eau oven,
LIMITED IMPACT (110) OPERATION governor
Greg f watcher
RECLAMATION PERMIT APPLICATION FORM Eaecutrve Duenor
Michael B Long
Division Director
CHECK ONE: X New Application (Rule 1.4) Conversion Application (Rule 1.11)
Amendment Application (C.R.S. 34-32.5-110)
Permit # M c~~ aJ -_ (provide for Amendments and Conversions of existing permits)
The application for a Conswction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (I) the application form;
(2) Exhibits A-1, Exhibit L, Addendum I, any sections of Exhibit 6.5 and Geotechniral Stability Exhibit, as required by the Office, and outlined in Rules
6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be sure to include one (1) complete si¢ned and
notarized IVORY ORIGINAL and one (1) copy ofthe completed Ivory application form, two (2) copies of Exhibits A-l, Exhibit L, Addendum 1, and
appropriaze sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the application fee described under (4) below. Exhibits should
NOT be bound or in a 3-ring binder, maps should be folded to 8 12" X 11" or 8 12" X 14" size. To expedite processing, please provide the informadon
in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, ALL information described below.
1. Aoolicaotlooerotor or compaov name (name to be used o0 permit): YUST RANCH
1.1 Type of organization (corporation, partnership, etc.): Sole Owner
1.2 I.R.S. Tax ID No. or Social Security Number:
2. O~erotion name foit, mine or site name): YUST RANCH GRAVEL PIT
3. Permitted acreage (new or existing site): 9. 9 permitted acres
3.1 Change in acreage (+) acres
Total Acreage in Permit Area ~ 9.9 acres
4. Fees:
4.1 New Application: $875.00 application fee
Amendment Fee (C.R.S. 34-32.5-125(li)): $575.00 application fee
4.2 Conversion Fee (from 1 I Od to 110 575.00 conversion fee (Rule 1.11.2(2))
5. Primary commoditie(s) to be mined: Road Base Pipe Bedding Gravel
5.1 Incidental commoditie(s) to be mined: 1. / Ibslfons/vr 2. / Ibsll'ons/yr 3. / Ibs/fons/vr
4. / Ibsll'ons/vr 5. / Ibs/fons/yr
51 Anticipated end use of primary commoditie(s)tn be mined: ['nn cr r„r•r; nn Rnartc
5.3 Anticipated end use of incidental commoditie(s) to be mined: