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TATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY fiECEIVED <br />Department of Natural Resources ~O/ <br />1313 Sherman St., Room 215 Y <br />Denver, Colorado 80203 FEB 2 5 2002 D I V I S I O N O F <br />Phone: (3031 b66-3567 MINERAL S <br />FAX: 1303) 832-8106 $c <br />Givision of Minerals and Geology G E O L O G Y <br />CONSTRUCTION MATERIALS R E C L A M A T I O N <br />MINING•SAFETY <br />LIMITED IMPACT (110) OPERATION <br />Bill Owens <br />RECLAMATION PERMIT APPLICATION FORM Governor <br />Greg E. Watcher <br />Ezecutive Director <br />Michael B Long <br />D[v'Fdon Director <br />CHECK ONE: New Application (Rule 1.4) Conr•ersion Application (Rule 1 1 i/ <br />Amendment Application (C.R.S. 34-32.5-110) <br />Permit # M - 86 -J~Q-_ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials limited bnpact (110) Operation Reclamation Permit contains three major pazts: (1) the application form; <br />(2) Exhibits A-J, Exhibit I, Addendum 1, any sections of Exhibi[ 6.5 and Geotechnical Stability Exhibit, as required by the Office, and outlined in Rules <br />6.1, 6.2, 6.3. 6.5, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be sure to include one (1) complete sieved and <br />notarized IVORY ORIGINAL and one (1) copy of the completed Ivorv application form, two (2) copies of Exhibits A-J, Exhibit L, Addendum 1, and <br />appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the application fee described under (4) below. Exhibits should <br />NOT be bound or in a 3-ring binder; maps should be folded to 8 1R" X 1 l" or 8 12" X 14" size. To expedite processing, please provide the information <br />in the forrrtat and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information described below. <br />Aoolicant/operator or company name (name to be used on permit): ~) httUE0.5AL, PEAT ND ~ rRA VEL~h, <br />1.1 Type of organization (corporation, partnership, e[cJ: GAR PoRA"TtoN <br />1.2 LR.S. Tax ID No. or Social Security Number: R 4 - n8A-0339 <br />2. Operation Dame (pit, mine or site name): I {~ R {G~-{-f ~ l"f <br />3. Permitted acreage (new or existing site): <br />3.1 Change in acreage (+) <br />'I'ota! Acreage in Permit Area <br />4. Fees: <br />4.l New Application: <br />Amendment Fee (C.R.S. 34-32.5-125(II)): <br />4.2 Conversion Fee (from 110d to 110 875.00 conversion fee (Rule 1.1 l.2(2)) <br />Primary commoditie(s) to he mined: 5 A N D ~ GaaUEI_ <br />(r,=$4 permitted acres <br />?.7.5 acres <br />9• ~ ~3- acres <br />51.094.00 application fee <br />188.0058 application fee <br />5.1 Incidental commoditie(s) to be mined: 1. - / lbs/pons/vr 2. / Ibs/I-ons/vr 3. / Ibs/T'onshT <br />4. / lbs/ponshr 5. / Ibs/('ons/vr <br />I <br />5.2 Anticipated end use of primary commoditie(s) to be mined: ®IJr Du ]V w~$7-RvCT r(r1w_t F QoA ~~AIS7lZ r lV(Arw)7: <br />5.3 Anticipated end use of incidental commoditie(s) to be vaned: <br />