1995-01-19_REVISION - M1977315 (8)

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REGULAR OPERATION (112) �{: RECLAMATION PERMIT APPLICATION FORM CHECK ONE: _ New Application (Rule 1.4.5) XXX Amen 1''cation (Rule 1.10) Conversion Application (Rule 1.11) JAN 9 19 w aw,;u, ,Vuneral Permit # M 77 315 (provide for amendments and co StE of existing permits) DNieiono)Mmeraf'sn 816W The application for a Regular Operation Reclamation Permit contains three major parts: (1) the application form; (2) Exhibits A-S and Geotechnical Stability Exhibit; and, (3) the application fee. When you submit your application, be sure to include one (1) signed and notarized original and four (4) copies of the application form, five (5) copies of Exhibits A-R and any required sections of Exhibit S and the Geotechnical Stability Exhibit, and a check for the application fee described under Section (16) on Page 3. 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 information in the format and order described in this form. "v GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, all information described below. ----------------------------------------------- ----- - ------- - 1 icant/operator or company name (name to be used on permit) : RP¢twny Paving CoLrZany 1.1 Type of organization (corporation, partnership, etc.) : None 1.2 I.R.S. Tax I.D. No. or Social Security Number: 84-9527796 2. Operation name (pit, mine or site name) : Pit No. 1 3. Permitted acreage (new or existing site) 75 permitted acres 3.1 Change in acreage (+ or -) (amendment or conversion) -17 acres 3.2 Total acreage in Permit area 53 acres 4 . Fees: 4.1 New Application _ $1,875.00 application fee 4.2 New Quarry Application $2.325.00 quarry application 4.3 Milling Application (Non-DMO) $3,100.00 milling application 4.4 Amendment Fee $1,550.00 amendment fee 4.5 Conversion to 112 operation (set by statute) $1,500.00 conversion fee 5. Primary commodities) to be mined: gravel 6. Name of owner of subsurface rights of affected land: Bestway Paving Company If 2 or more owners, refer to Exhibit 0. 7. Name of owner of surface of affected land: Restwa�L Paving Company 8. Type of mining operation: xy Surface _ Underground 9. Location Information: the center of the area where the majority of mining will occur lies in: Weld COUNTY: PRINCIPAL MERIDLAN (check one) : �`�` 6th (Colorado) _ 10th (New Mexico) _ Dte SECTION (write number) : S 2 TOWNSHIP (write number and check direction) : T. KX North South RANGE (write number and check direction) : R _ East XX West QUARTER SECTION (check one) : xXs NE NW SE — SW _ QUARTER/QUARTER SECTION (check one) : NE — K — SE SW GENERAL DESCRIPTION (miles and direction from nearest town and approximate elevation).: Northwest corner of the City of Greeley, 4700 elevation