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~/fig, o0 <br />OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ^ ^~~ v~r I <br />Department of Natural Resources FOR SCAN <br /> <br />1313 Sherman SL, Room 215 N/NG <br />RECEeVED <br />Denver, Colorado 80203 <br />Phone: (303)866-3567 <br />FAX <br />(303) 832 <br />8106 <br />~ <br />: <br />- APR 7 1 2~I~2 ° <br /> CONSTRUCTION MATERIALS <br />Division of Minerals and Geology <br /> REGULAR (112) OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: _ New Application (Rule 1.4.5) <br />DIVISION OF <br />MINERALS <br />GEOLOGY <br />AEC LAMATION <br />MINING•SAFETY <br />Bill Owens <br />Governor <br />Greg E Watcher <br />Executive Director <br />x Amendment Application (Rule 1.1 ichael B. Long <br />~ivision Director <br />Conversion Application (Rule 1.11) <br />Permit # M - 86 _ 159 __ (provide for Amendments and Conversions of existing permits) <br />The applicaflon for a Construction Materials Regulaz 112 Operaflon Reclamation Permit contains threemajorpazts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical S[abilityExhibit; and (3) [he applicaflon fee. When you submit your <br />application, be sure to include one (1) complete sinned and notarized IVORY ORIGINAL and four (4) copies of the completed Ivory <br />applicaflon form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a checkfor the <br />applicaflon fee described under Secflon (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded [0 8 lYl" X 11" <br />or 8 1/2" 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. '/ ~~ - O <br />1. Applicant/operator or company name (name to be used on permit): Lafarge West, Inc. <br />1.1 Type of organization (corporation, paztnership, etc.): <br />1.2 LR.S. Tax LD. No. or Social Security Number: <br />2. Operation name (pit, mine or site name): Courtner Pit - Amendment <br />3. Permitted acreage (new or existing sitel: 259 permitted acres <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Fermi[ azea <br />4. Fees: <br />" 4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: Sand Gravel <br />0 acres <br />259 acres <br />$2.344.00 application fee <br />$2.906.00 quarry application <br />$1.938.00 amendment fee <br />$2,344.00 conversion fee <br />5.1 Incidental commoditie(s) to be mined: 1. n~a - lbs/Tons/vr <br />Fill <br />2. / lbs/I'ons/vr <br />3. / lbs/Tons/vr 4. / lbs/fons/vr 5. / lbs/I'ons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: ~vnJ ~.• ~ ~.ln /1/I -1<v;•s!S <br />5.3 Antcipated end use of incidental commoditie(s) to be mined: C,r„~ 1-- ~l .e+, ~Gl _ ~v %~ l s ~I~ 4 t) ~ <br />