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~re~j~-r` 9587 X1,938°-°- <br />STATE OF COLORADO <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: (3~i832~D~0PY <br />fOR SCANN/NC CUNSTRUCTIONIKATERIAIS <br />REGULAR (112) OPERATION <br />REr'r.st-~raTION PERMTT APPLICATION FORM <br />RECEIVED~~~ <br />MAR 112003 DIVISION DF <br />MINERALS <br />Division of Minerals and l~lb L O G Y <br />REG LAMATION <br />MI NIN G•SAFETY <br />Bill Owens <br />Governor <br />Greg E. Walther <br />Fxetutive Director <br />CHECK ONE: X There is a Ft1e Number Already Assigned W this Operation <br />Ronald W. Cattany <br />Permit # M -2 0 40=0 4 9 (Please reference the file n~ber currently assigned to this operation) /Ming Division Director <br />New Application (Rule 1.4.5) X Amendment Application (Rule 1.10) / ~ ~ _ f <br />_ Conversion Application (Rule 1.11) <br />Permit # M - 2 0 0 0 - 0 4 2 ~ (provide for Amendments and Conversions of existing permits) <br />The application for a Cansttuction Materials Regular 112 Operation Reclanwtion Pemtit contains three major parts: (1) the application form; <br />(2) F.xhtbits A-S, Atlthendnm 1, a~ sections of Exhibit 65 (Geotec}mical Stability Exhibit; and (3) Ste application fee. When yon submit your <br />application, be slue to inchnde one (1) co~lete signed and notarized IVORY ORIGINAL and ante (1) copy of the completed I~ application <br />form, two (2) copies of Exhrbits A-S, Addendum 1, appropriate swtions of 6.5 (Geotechmcal Stability Exhibit, and a check for the application <br />fee descnbed under Section (4) below. Exhibits ~ranld NOT be bound or m a 3-ring binder; maps should be folded to 812" X 11" or 8 1/2" <br />X 14" size. To expedite processing, please provide the information in the fomrat and order descnbed'm this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the apace provided, ALL information requested below. <br />AonlicanUocerafororromoanvname(nametobeusedoncetntit):Louisiana Land and Gravel Company,LLC <br />1.1 Type oforgattization(corporation,pmtnership,etc.): Limited Liability Company <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: <br />2. Ooeration name (oit- mine or ales name): <br />3. Permitted acreage (new or esistine site): <br />3.1 Change in acreage (+) <br />3.2 Total acreaee in Permit area <br />Angie Pit <br />4. Fees: <br />4.1 New Application <br />4.2 New Quazry Application <br />4.4 Amendment Fee <br />45 Conversion to 112 operation (set by statute) <br />5. Primary rnmmoditie(s) to be mined: Gravel <br />5.1 Incidental commoditie(s) to be mined: 1. Ibs!I'ons/vr <br />1 ~~ permitted acres <br />- 6 acres <br />154 <br />acres <br />52.344.00 application fee <br />$2.906.00 quarry application <br />51.938.00 amendmcar fee <br />52.344.00 conversion fee <br />2. / Ibs/Tons/vr <br />3. / IbslTonslvr 4. / lbslfons/yr S. ! lbs/Tons/vr <br />5.2 Anticipated endnseofptimarycommoditie(s)tobemined: Construction Products <br />5.3 Anticipated end ttse of incidental commoditie(s) to be mined: N ~ A <br />