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<br />Ra,~. os 28 <br />ck# ~~~ 3 <br />STATE OF <br />DIVISION OF MINERALS AND GEOLOGY RF 1 <br />Depanrnenl of Natural Rewurces 1997 <br />171 J Sherman $1., Room 2 i $ ~~~ ~ Q <br /> <br />Denver, Colorado 80207 I <br />I~ <br />I'hnne~. 17071 Rh6-7567 • <br />FA%: (7071 8 7 2-8105 C Ory <br /> ICO Q1 f:uR2 l dl' c' ~„ UEPARTMEhFF OF <br /> (11YIS NATURAL <br /> COHSTRUCTIOH MATERIAIS RESOURCES <br />LIMITED INPACT (110) OPSRATZOH Rny ROTH <br />RECLAMATION PERMIT APPLICATION FORM Gavomr <br />lames S. LochheaA <br />f Rtfuliv! Dlreflo. <br />Michael R Lnn~; <br />Divnlon Di¢am <br />CHECK ONE: XX Hew Application (Rule 1.4) _ Amendment Application (C.R.S. 34-32.5-110) <br />_ Conversion Application (Rule 1.11) <br />Permit # - - - provide for Amendments and Conversions of <br />existing permits) <br />This application for a Limited Impact (110) Operation Reclamation Permit contains three major <br />parts: (1) the application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of <br />Exhibit 6.5 (Geotechnical Stability Exhibit; as required by the Office, and outlined in Rules <br />6.1, 6.2, 6.3, 6.5 and 1.6.2(1)(b); and (3) the application fee. When you submit your <br />application, be sure to include one (1) sinned and notarized IVORY ORIGINAL and one (1) copy <br />of the completed ivory application form, two (2) copies of Exhibits A-J, Exhibit L, Addendum <br />1, appropriate sections of 6.5 (Geotechnical Stability Exhibit) as required, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in <br />3-ring binders; mope should be folded to 8 1/2" X 11" or 8 1/2" X 14" size. To expedite <br />processing, please provide the information in the format and order described in this form. <br />---- <br /> <br /> <br /> <br />. --------------------------------------------------------- - -- - ----- <br />-- I-'-I-I------- <br />GENERAL OPERATION INFORMATION ~'~ ~ I <br />Type or Print clearly, in the space provided, all information described bellow. <br />Applicant/Operator Name (name to be oa Permit): <br />Siloam Stone <br /> 1.1 Type of Organization (corporation, partnership, etc.): NA <br /> 1.2 I.R.S. Tax ID No. or Social Security No.: <br />2. Operation Name (Pit, mine or site name): Pinon Mine <br />3. Permitted Acres (new or exintina site): 6.26 permitted acres <br /> 3.1 Change in (+ or -) ------ acres <br /> 3.2 Total acres in Permit Brea 6.26 acres <br />4. Fees• <br /> 4.1 New Application: S875.00 application fee <br /> 4.2 Amendment Fee: e~'.~^~ application fee <br /> 4.3 Conversion Fee ( from 110d to 110 conversion fee (Rule 1.11.2(2) <br />5. Prima ry commodities(s) to be mined: Rip-Rap Decorative stone Building stone <br /> 5.1 Incidental commodities(s) to be mined: 1. Ballast/ 5,000 3~ae/Ton/vr <br /> 2. Road Metal/ 8,000 3-be/Ton/yr 3. / lbe/Ton/Vr <br /> 4. / lbs/Ton/vr 5. / lbs/Ton/vr <br /> 5.2 Anticipated end use of primary commodities(s) to be mined: Construction Mats. <br /> 5.3 Anticipated end use of incidental colLmlodities(s) to be mined: Coast. Mats. <br />