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<br />DIVISION OF MINERALS AND GEOLOGY <br />Drpanment of Natural Resources <br />131 1 Sherman 51.. Ruum ? 15 <br />Denver, Colorado HU!Ul <br />Pnone: uml Hnb-3sn~ <br />FAX (5031 HS?-HI06 <br />,~ III IIIIIIIIIIIIIIII <br />of coLOr~Do <br />RECEIVED CONSTRUCTION MATERIALS <br />REGULAR (1 l2) OPERATION <br />~~ <br />DIVISION O F I <br />MINERALS <br />& I <br />GEOLOGY <br />R E C L A M A T I O N <br />MININ G'SAFETY <br />RECLAMATION PERMIT APPLICATION FORM Bill Owens <br />Of"T t 8 2000 Governor <br />ll~~ Greg E. Walther <br />E..ecw,ve Dvenor <br />Division of Minerals and Geology ichael B. Lon <br />CHECK ONE: _ New Application (Rule 1.4.5) t'1C Amendment Application (Rule I.10~',~,:.on Director <br />Conversion Application (Rule I.I I j <br />Permit # M - 80 _ 239 •_ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Mazerials Regular 112 Operation Reclamation Petmit contains three major parts: (I) 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 (I) complete sieved and notarized IVORY ORIGINAL and four (4) copies of the completed Ivor; <br />application form, five (S) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibiu should NOT be bound or in a 3-ring binder; maps should be folded to <br />8 1/2" X 1 I" 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. <br />I. Applicaot/ooerator or comoaay Dame (name to be used o0 oermitl: l+,offat County rtoad Dept. <br />1.1 Typeoforgani7ation(corporation,parntership,etc.): Local GoVertunent <br />1? I.R.S. Tax I.D. No. or Social Security Number: <br />2. Operation name (pit, mine or site name): Sweeney Pit ,~30 <br />3. Permitted acreaee (Dew or existioe sitel: <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4? New Quarry Application <br />4.3 Milting Application (Nan-DMO) <br />4.4 Amendment Fee .. yl, 938.00 <br />4.S Conversion to 112 operation (set by statute) <br />S. Primary commoditie(sl to be mined: Sand Gray e 1 <br />S.l Incidental commoditie(s) to be mined: I. n~A - Ibsffonslvr <br />33 permitted acres <br />50 acres <br />83 __ acres <br />81.875.00 application fee <br />52.325.00 quarry application <br />53.100_.00 milling application <br />r A6 amendment fee <br />51.875.00 conversion fee <br />2. J Ibslfonslvr <br />3. / IbslTons/vr 4. / Ibs/fons/vr S. / Ibsn'ons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: ~ Road Dtaintenane e <br />N N <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />