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<br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY _ <br />Department of Natural Resources ~qp~ ~ g 2005 `~-~-~~'''i~~~ gym- ~ <br />1313 Sherman St., Room 275 App~~l Cd-~TOy" COLORADO <br />Denver, Colorado 80203 D[ v[ S[ o N o f <br />Phone: (303) 86b3567 ~ __ Division ol~y~glg.~~ ~.pE~~ M I N E~ RA L S <br />FAx: (303) 832-8106 REGIILAR (112) OPERATION G E O L O G Y <br />RECLAIVIATIONPERIVIITAPPLICATIONFORM IRECLANATION•NINING <br />SAFETT•SCIFNCE <br />Bill Owens ' <br />CHECK ONE: ~ There G a File Number Already Assigned to this Operation covemor <br />Russell George <br />Permit # ~-~-~ _ (Please reference the file mrmber cu[rently assigned to this operation) ExeMive Director <br />_ New Application (Rule 1.4.5) x Amendment Application (Rule 1.10) <br />_ Converoion Application (Rule 1.11) <br />Permit # _ vhf -g~-f~-_ (provide for Amendments end Conversions of testing permits) <br />Ronald W. Caaany <br />Division Director <br />Natural Resource Trustee <br />The application far a Construction Materials Regular 112 Operation ReclamationPermit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendum i, auy sections of Fachibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fx. Whenyou submityou< <br />application, be sure to include one (1) complete signed andnotarized ORIGINAL and one Q) copy of the completed applicatienform, two (2) <br />copies ofExhmbits A-S, Addendum 1, appropriate sections of6.5 (Geotechnical Stability Exhbbit, and a check far the applicafi~ fce desrnbed <br />under Section (4) below. Exhibits should NOT be bound ~ in a 3-ring binder; maps should be folded to 8112" X 11"or 81/2" X 14" size. To <br />~P~ P~~B. Please provide the information in the format and order described is this foam. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, In the <br />1.1 Type of organization (corporaticn, partnersh[p, etcJ: _ j1 <br />1.2 IRS. Tex I.D. No. or Social Security Number: .Ss4 -- <br />requested below. <br />2. Oper ation name (ok, mine or site nameY. f tin// IOE~C-' / %O UNTi 9 /N ~T/J ~'. K f ~T <br />3. P~erm ttted acreage (new orklisrine site):) ~_ permitted acres <br /> 3.1 Change in acreage <+) -i- IFS. 7 acres <br /> 3.2 Total acreage in Permit area ~ • 7 acres <br />4. Fees: I...,; ;• ~ ~~,.J <br /> 4.1 New Application $2.344.00 application fee <br /> 4.2 New Quarry Application 52.906.00 quarry application <br /> 4.4 Amendment Fee 938. amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) 44. conversion fee <br />5. Prim ary commoditi~sl to be mined: ,~'jE.STO/1/F <br /> 5.1 htcidenta] commoditie(s) to be mined: 1.~//c lbs/I'ons/yT 2. / Ibs/fons/vr <br /> 3. / ]bs/Tans/vr 4. / lbs/fonslvr 5. / lbs/Ton.9/vr <br /> 5.2 A>icipated end use of primary commoditie(s) to be mined: Zj7. e,2T <br />A~ [ /TN~iP ~i aa~ea n x~. r~~ <br /> 5.3 + <br />Anticipated end use of incidental commoditie(s) to be mined: ~~A <br /> Office of Office of Colorado <br /> Mined Land Reclamation Active and Inactive Mines Geological Survey <br />