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<br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />STATE OF COLORADO <br />DIVISION OF <br />MINERALS <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />GEOLOGY <br />RECLAMATION <br />MINING•SAFETY <br />RECLAMATION PERMTT APPLICATION FORM Bill Owens <br />CHECK ONE: _ New Application (Rule 1.4.5) <br />XX Conversion Application (Rule 1.11) <br />Governor <br />Greg E. Walther <br />Executive Director <br />Amendment Applicafion (Rule 1.1 ¢hael B. Long <br />ivision Director <br />Permit# M - 1979. 058__ (provideforAmendmentsandConversionsofexisting permits) <br />The application for a Construction Iviaterials Regulaz 112 Operation Reclamation Permit contains threemajor pazts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit yots <br />application, be sure to include one (1) complete siened and no[azized IVORY ORIGINAL and four (4) copies of the completed Ivory <br />application farm, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geo[echnical Stability Exhibit, and a check for the . <br />application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 12" X 11" <br />or 8 1 /2" X 14" size. To expedite processing, please provide the information in the format and order described in [his form <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. _ <br />1. Applicant/operator or comoanv name (name to be used on permit): ROUTT COUNTY <br />1.1 Type of organization (corporation, paztnership, etc.): Government <br />1.2 LR.S. Tax LD. No. or Social SectsityNumber: 84-6000-802 <br />2. Operation name (oit. mine or site namel: Funk & Hooker Pit <br />3. Permitted acrease (new or existine sitel: 8.4 permitted acres <br />3.1 Change in acreage (+) 39 .2 acres <br />3.2 Total acreage in Permit azea 4 7.6 acres <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Pee <br />4.5 Conversion to 112 operaflon (set by statute) <br />Primary commoditie(s) to be mined: Gravel <br />5.1 Incidentalcommoditie(s)tobemitted: 1. r_,-a.rP1-(,n,nnnlb/vr <br />3. / 1bslTons/vr 4. _ / lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie{s) to be mined: <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />$2344.00 application fee <br />$2.906.00 quarry application <br />$1.938.00 ~ndmentfee <br />$2.344.00 / conversionfee <br />2. / lbs/I'ons/vr <br />5. / lbs/Tonslvr <br />