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~ <br />1 <br />III III'IIIIIII~IIII • 392439 06/06/20~1Zt30603 P46 RPP <br />" ~ 999 2 of 32 R 0.00 D 0.00 Elbor! County CO <br />~ lt~~ ~ Ur Lv~UI~~U <br />DIVISION OF MINERALS AND GEOLOGY <br />Depanmem of Natural Resources <br />i 31 ; tiherman Sc, Rnom ?15 <br />Denver, Cnbra(lu H0203 <br />Phone: 1 JIIJ 1866-356 i <br />FAx 1.1071 HJ2~8106 <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />\~ <br />DIVISION O F ~ <br />MINERALS <br />GEOLOGY <br />R E C L A M A T I O N <br />MINING•SAFETY <br />RECLAMATION P RM1T APPLICATION FORM Bill Owens <br />f~ECEIVED `°ve`°°' <br />~ Greq E. Walther <br />Executive D~reclor <br />CHECK ONE: ~ ' 1Yew A lication Rule 1.4.5 JUN ~ ~ ZOOO~ Amendment A lication Rule I.10~~.t1 chae~ s Eons <br />PP ( ) PP ( bwlslon Dlredor <br />~ Convenion Application (Rule <br />miJi3iDrt of Minerals & Geology <br />Permit # M -~` ~- 11~-_ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Mazerials Regular l 12 Operation Reclamation Permit contains three major parts: (I) the application form; <br />(2) Exhibits A-S, Addendum 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) co~lete signed and notarized IVORY ORIGINAL and four (4) copies of the completed Ivory <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check far <br />the application fee described under Section (4) below. Exhibits should NO be bound or in a 3-ring binder; maps should be folded to <br />8 1/2" X I I" or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described N this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, AL information requested below. <br />1. AooGcant/operator or comoanv Dame (name to be used on permit(: C` I R 2 d2 T L n ~_ ~, yi ~t,o ~ h aln j <br />1.1 Type of organi7arion (corporation, partnership, etc.): L ~ . , ro ~ .( G o ~ . P Ji lA ,r.. e.., ~ <br />l~ I.R.S. Tax I.D. No. or Social Security Number: S V - 6 0 n 7 6 3 <br />2. Ooetatioo Dame (nit, mine or site oamei: <br />3. Permitted acreage (new or existing site(: <br />3.l Change in acreage (+) <br />31 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.3 Milling Application (Non-DMO) <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operazion (set by <br />statu[e) <br />/^ <br />/ <br />5. Primary commoditie(s) to be mined: l n e~ 1 <br />'1 ~. , ~ permitted acres <br />y A . G, acres <br />7 t . ~ acres <br />51.875.00 application fee <br />52.325.00 quarry application <br />3 100.00 milling application <br />1550.00 amendment fee <br />875.00 conversion fee <br />5.1 Incidental commoditie(s) to be mined: I. ~ d O~ ~ (701_ b0 2. / Ibs/I ons/vr <br />3. / Ibs?ons/vr 4. / Ibs/Tons/vr 5. / Ibs/Ions/vr <br />5:2 Anticipated end use of primary commoditie(s) to be mined: S r^ ~ F Q L P_ r~~^~ l2a r,e I F~_I~ na id S <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: ~7u~~c"~ c_ P . l!r O a J C'.'~~L~o <br />