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, iii iiiiiiiiiiiiiiii <br />5 TATS OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1373 Sherman $1., Room 213 R DIVISION O .` <br />Denver, Coiorado x0203 <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS ~~~~ M l N& R A L J <br />FA%: (3031 B3?aloe REGULAR (112) OPERATION ~/ <br />~~r`` ~Nfp O GEOLOGY <br />RECLAMATION PERMIT APPLICATIIJt'a'~j~RM B R E C L A M AT I O N <br />np/~, ~t~Of ~MINING•SAFETY <br />/lprd~s <br />CIiFCK ONE: There is a File Number Already Assigeed to this Operatioe dn~Gep709/~ cov~no~s <br />Greg E. Walther <br />Petmit # M - 78. 225. L (Please reference the fde number cutrenthv assigned to this operation) Execuave o~reaor <br />hLChael a Lang <br />New Appbcation (Rule 1.4.5) _ Amendment Application (Rule 1.10) orv~sion oireao. <br />X Conversioe Application (Rule 1.11) <br />Permit # M - 78 _225 _ L (provide for Amevdmeets and Covvenions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major pare: (1) the applcation fotm; <br />(2) Exhibits A-S. Addendum 1, any sections of Exhibit 6.5 (Geotecfmical Stability Exhtbit; and (3) the application fee. When you subnit your <br />application, be sure [o include one (1) complete sieved and notarized IVORY ORIGINAL and four (4) copies of the completed Ivor, <br />appbcation form, five (5) copies of Exhibits A-S. Addendum 1, appropriate sections of 6.5 (Geoteclmical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or is a 3-ring binder; maps should be folded to <br />8 1 /2" X 11 " or 8 1 /2" X 14" size. To expedite processing, please provide the information in the format and order desttibed in this form. <br />GENERAL OPERATION INFORMATTON <br />Type or print clearly, ie the space provided, all information described below. <br />1. AoylicavUocerator or rnmoaov name (name to be used ov vermi0: <br />1.1 Type of organization (corporation, partnership, etc.): GOVERNMENTAL ENTITY/ROAD & BRIDGE DISTRICT III <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: <br />Qu' ~.r.~r `r1E~ <br />2. Overatioe name (pit, miee or site vamel: McVEY PIT "N@~ -1-6 <br />3. Permitted acreatee (new or elsisties! site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4. I New Application <br />4.2 New QuatTY Application <br />4.4 Amendment Fee <br />4.5 Conversion to 1 12 operation (set by statute) <br />~. Primary commoditie(s) to be mieed: SAND GRAVEL <br />8.57 petmittedacres <br />f S 1~_ acres <br />160.00 acres <br />$2.344.00 application fee <br />$2.906.00 quarry applica«on <br />$1.938.00 amendment fee <br />$2 344.00 conversion fee <br />5.1 Incidental commoditie(s) to be mined: 1. / 16s/1'ons7vr 2. / 1bslTons/vr 3. / lbs/fons/vr <br />4. / Ibs/fons/vr 5. / lbs/fooJvr <br />~.2 Anicipeted end use of primary commodiie(s) to be mined: UNTIL SUPPLY IS DEPLETED <br />5.3 Anticipated end ttse of incidental commoditie(s) to be mined: N / A <br />