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<br />STt~TE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Drpatlmenl of Natural ReSOUrCeS <br />111.1 Sherman SI , Rwm ? 15 <br />Denver, Grlurado µU'?UJ <br />Phune: IJUJI µfiG 156? <br />RECElVEp <br />FAx.unJ,aJZ-aln~ t)C•i ~9~gg~ <br />CONSTRUCTION MATERIALS DivlSion of Minerab & Ge010gy <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />~~: <br />DIVISION O F I <br />MINERALS <br />& i <br />GEOLOGI'~ <br />REC LA MATION~ <br />MINING•SAFETY <br />ell oven, <br />envemnr <br />G.epE Walchcr <br />E+ecutive D~renor <br />CHECK ONE: New A lication Rule 1.4.5 X Amendment A lication Rule 1.10((~~11'cnael a Env,; <br />PP ( ) PP ( biasion Dirennr <br />`Conversion Application (Rule 1.11) <br />Permit # M - 80 _ 085 __ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Mazerials Regulaz 112 Operation Reclamation Permit contains three major parts: (I) the application form; <br />(2) Exhibits A-S, Addendtun 1, any sections ofExhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) comQlgte sieved and notarized IVORY ORIGINAL and four (4) copies of the completed Ivor <br />application form, 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 I /2" X I l" or 8 112" 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, io the space provided, ALL informatioo requested below. <br />A~olinnUooerator or comoanv name (name to be used on oermitl: ELAM CONSTRUCTION , I NC . <br />I.I Type of organization (corporation, parutership, etc.): COLORADO CORP . <br />1.2 I.R.S. Tax I.D. No. or Social Securiry Number: <br />2. <br />3 <br />Ooentionnsme(oit,mioeorsitensme): VAGNEUR GRAVEL PIT <br />Permitted acres¢e (oew or e><istine site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. <br />Fees: <br />4.1 New Applicarion <br />4.2 New Quarry Application <br />4.3 Milling Application (Non-DMO) <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(sl to be mined: SAND AND GRAVEL <br />5.1 Incidental commoditie(s) to be mined: I. NONE - Ibs/'fons/vr <br />3. / tbs?ons/vr 4. / Ibs/1'ons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: - <br />104.7 permitted acres <br />0.0 acres <br />104.7 acres <br />$1.875.00 application fee <br />52325.00 quarry application <br />$3.100.00 milling application <br />$1.550.00 amendment fee <br />$1.875.00 com•ersion fee <br />2. / IbsrfonsJvr <br />5. / Ibs/I'ons/v'r <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />