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