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TATE OF COLORADO <br />DIVISION OF MINERALS AND GEt~' E I V ED <br />Department of Natural Resources <br />Denver, Colorado 80203215 NOV 06' ~ F~LE COPY <br />Phone: (303) 866-3567 <br />FAX: (3031832-8106 Division of Minerals and Gealopy FpR s~ANNIN <br /> CONSTRUCTION MATERIALS <br /> REGULAR (112) OPERATION <br /> RECLAMATION PER1111T APPLICATION FORM <br />CHECK ONE: There is a Foe Number Already Asah~ed to this Operation <br />Permit # M --_-_ (Please reference the file number currently assigned [o [his operation) <br />_ New Application (Rule 1.4.5) R Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.1 ]) <br />Permit # M _ 1980.136 _ (provide far Amendments and Conversions of existing permits) <br />DIVISION O F <br />MINERALS <br />GEOLOGY <br />RECLAMATION <br />MIN ING•SAFETY <br />Bill Owens <br />Governor <br />Greg E. Walther <br />ExecNive Director <br />Ronald W. Cattany <br />Acting Division Director <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 I, a~ sections of Exlubif 6.5 (Creotechnical Stability Exhbit and (3) the application fee. When you submit your <br />appbcation, be sure to include one (1) complete siffied and notarized IVORY ORIGINAL and one (1) copy of the completed I~ application <br />form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotecllnical Stability Exhibit, and a check for the application <br />fee descn'bed ender Section (4) below. Exhibits shonld NOT be hotrod or in a 3-ring bivder, maps should be folded to 8 1/2" X 1 ]" or 8 1/2" <br />X 14" size. To expedite processing, please provide the information in the format and order descnbedm this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, hn the space provided, ALL information requested below. <br />1. AinlicanUoceratororcomoanvnama(nametobensedoncermkl: Lafarge West, Inc. <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />1.2 LRS. TaxLD. No. or Social Security Number: <br />2. Operation aame tpht, mine or sRe Hamel: Chambers Pit - t3-1980-136 <br />3. Permitted acreage (aew or esistine site): 149 +/- pennined acres <br />3.1 Change in acreage (-+-) -0- acre <br />3.2 Tota: acreaee itI PerL~~t area 149 +/- acre, <br />4. Fees <br />4.1 New Application $2.344.00 application fee <br />4.2 New Qnarry Application $2 906.00 quarry application <br />4.4 Amendment Fee $1.938.00 amendmealfee <br />45 Conversion to 112 operation (sei by statute) 52344.00 conversion fee <br />~. Primary commoditie(s) to be mixed: sand gravel roadbase <br />>.1 Incidental commodite(s) to be mined: 1. - Ibs/Toashr 2. / Ibs/fonsltT <br /> 3. / Ibs/Tons/yr 4. / lbs/Tons/vr 5. / 1bsrTonshr. <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Asphalt, concrete, construction materials <br />5.3 Anticipated end nse of incidental commoditie(s) to be mined: <br />