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999 <br /> STATE OF COLORAD6 <br /> DIVISION OF MINERALS AND GEOLOGY <br /> Department of Natural Resources <br /> 1313 Sherman Sr., Room 215 RECEIVED <br /> Denver,Colorado 80203 D I V I S I O N O F <br /> Phone:130 11 866-3 5 67 APR 2 9 �ggg MINERALS <br /> 03 FAX:131 832 11106 <br /> Division of Minerals&Geol GEOLOGYLT <br /> RECLAMATION <br /> CONSTRUCTION MATERIALS �Y MINING-SAFETY <br /> REGULAR(112)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM ell O-ens <br /> Governor <br /> • Cr,g E Watcher <br /> Execmme Dirennr <br /> CHECK ONE: _New Application Rule 1.4.5) Amendment Application Rule 1.10((,+�12.ol B.Long <br /> PP ( PP ( bivismn Director <br /> Conversion Application(Rule I.1 1) <br /> Permit# M At - 3 -_ (provide for Amendments and Conversions of existing permits) <br /> r <br /> The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts:(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 your <br /> application, be sure to include one (1) complete signed and notarized IVORY ORIGINAL and four (4) copies of the completed Ivory <br /> application forth,five(5)copies of Exhibits A-S,Addendum I,appropriate sections of 6.5(Geotechnical Stability Exhibit,and a check for <br /> the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to <br /> 8 1/2" X I I"or 8 I/2" X 14"size. To expedite processing,please provide the information in the format and order described in this form. <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly,in the space provided,ALL information requested below. <br /> 1. A licant/o erator or company name name to be used on ermit : IV iclbL5 CtE"a P (f <br /> 1.1 Type of organization(corporation,partnership,etc.): pp _ <br /> 1.2 I.R.S.Tax I.D.No.or Social Security Number: ��" !! �nn��5 <br /> 2. Operation name(oit,mine or site name): lu l utLL t;j l7f�kft P n' <br /> 3. Permitted acrezim(new or existing site): _�� permitted acres <br /> 3.1 Change in acreage(+) 5� acres <br /> 3.2 Total acreage in Permit area 4-7. 9 s acres <br /> 4. Fees: <br /> 4.1 New Application S1.875.00 application fee <br /> 4.2 New Quarry Application S2.325.00 quarry application <br /> 4.3 Milling Application(Non-DMO) $3.100.00 milling application <br /> 4.4 Amendment Fee $1,550.00 amendment fee . <br /> Conversion to 112 operation(set by statute) $1,875.00 conversion fee <br /> 5. Primary commoditie(s)to be mined: <br /> 5.1 Incidental commoditie(s)to be mined: 1. MAY - Ibs/Tons/yr 2. Ibs/Tons/vr <br /> 3. / Ibs/I'ons/vr 4. / Ibs/Tons/ r 5/..'' / L Ibs/Tons/ r <br /> 5.2 Anticipated end use of primary commoditie(s) eA s)to be mined: le I# I r L Lo l 5tRlc TI h1A 1 944 ,t/l S <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: lbtiril, <br />