2004-06-18_PERMIT FILE - M2004037

• Permit No: M2004037
• IBM Index Class Name: Permit File
• Doc Date: 6/18/2004
• Doc Name: 110c Appl Pkt
• From: John M. Everitt
• To: DMG
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
Department of Natural Resources
1313 Sherman St., Room 27 5 C O L O RA D O
Denver, Colorado 80203 D t v t 5 t O N o r
Phone: [phone] CONSTRUCTION MATERIALS MINERAL S
FAX: [phone]
LIMITED IMPACT (110) OPERATION G E O L O G Y
0.ECLANATION•NINING
SAFETY•SCIENCE
RECLAMATION PERMTT APPLICATION FORM
Bill Owens
Governor
CHECK ONE: There is a File Number Alread Assi ed to this O eration Greg E. Walther
y ga P Executive Director
Pemilt # M -~ _ _ (Please reference the file nttmber currently assigned to this operation) Ronald w. Cattany
Division Director
XX New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Natural Resource Truztee
Conversion Application (Rule 1.1 l)
Permit # M -_ -_ (provide for Amendments and Conversions of existing permits)
The application for a Cotutruction Materials Limited Impact (I 10) Operation Reclamation Pemilt contains throe majorparts: (1) the application
form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the Office, and
outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(6); and (3) the application fee. V/hen you submit your application, be sure to include one
(I) comolete signed and notarized IVORY ORIGINAL and one (1) copy of the completed I~ application form, two (2) copies of Exhibits
A-J, Exhibit L, Addendum 1, and appropriate 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 1/2" X 11" or 8 1 /2" X 14"size.
To expedite processing, please provide the infomtation in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or print ckady, in the apace provided, ALL information described bebw.
1. Apolicant/oaerator or comnanv name (uame to be used oe cermkl: John M. Everitt
1.] Type ofarganization(corporation,parlnership,etc.): Individual
1.2 1.2 I.R.S. Tax ID No. or Sceial Security Ntunber:
2.
3.
4.
5.
Oneration name (nit. mine or ske Hamel:
Permitted acreage (new or eaistina site): ~~ ~~ U'~
3.1 Change in acreage (+) (~'~ ~ a~ ~~
3.2 Total Acreage in Permit Area P~~'~~~ ~' ~ 1C`~>
Fees:
4. ] New Application:
Amendment Fee (C.R.S. 34-32.5-] 25(II)):
42 Conversion Fee (from 110d to 110 $875.00 conversion fee (Rule 1.11.2(2))
Primary rnmmoditie(s) to be mined: Gravel
9.9 permitted acres
acres
9.9 acres
1 094.00 application fee
719.00 application fee
5.1 Incidental commoditie(s) to be mined: I. / lbs/fons/vr 2. / ]bs/fons/vr 3. / ]bslTorLShr
4. / Ibs/I'ons/vr 5. / Ibs/Tons/vr
5.2 Anticipated endtueofprimarycommoditie(s)tobemined: Aggregate for concrete
Anticipated end use of incidental commoditie(s) to be mined:
Office of
Mined Land Reclamation
Office of
Active and Inactive Mines
Colorado
Geological Survey