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<br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGI' <br />D~.~parl m~~nl pl Nalurdl ReSpnlCet <br />I ; 15hr~rman SL, Room ? I S <br />Ue:~; c,. Culorarlo BO?0l • <br />rn,roc I;OaI fl66-3sr,~ <br />r.\Y Ii0^,r Y,43 8106 - ~... ~~~ . <br />Received <br />CONSTRDCTION MATERIALS <br />MAY 3 Q 1997 REGIILAR OPERATION (112) <br />RECLAMATION PERMIT APPLICATION FORM <br />DENVER <br />OFFICE <br />~~ <br />DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />Durango Field Office <br />Division of Minerals 8 Geology <br />Roy Rome <br />Govemo~ <br />lames 5. Lochhead <br />Ecew~ive Director <br />michael B Long <br />Dn~s~on Dvecmr <br />CHECK OCiE: New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />X Conversion Application (P.ule 1.11) <br />Permit # M - 78 - 0 - 66 (provide for Amendments and Conversions of <br />existing permits) <br />The application for a Regular 112 Operation Reclamation Permit contains three major parts: (1) <br />the application form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical <br />Stability Exhibit; and (3) the application fee. when you submit your application, be sure to <br />include one (1) complete sinned and notarized IVORY ORIGINAL and four (4) copies of the completed <br />ivory application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 <br />(Geotechnical Stability Exhibit, and a check for the application fee described under Section (4) <br />below. Exhibits should not be bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" <br />or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and <br />order described in this form. <br />GENERAL OPERATION INFOP,MATION <br />Type or print clearly in the space provided the information requested below. <br />----- -------- ------- <br />---------- ---------- --------------------------------------------------------- <br />1. Applicant/operator or company name (name to be used on permit): <br />Rio Grande County <br />1.1 Type of organization (corporation, partnership, etc.): CoV ernmental <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: <br />2. Operation name (pit, mine or site name): 19 South Pit <br />3. Permitted acreage (new or existing site) ~ $~ permitted acres <br />3 .1 Change in acreage (+ or -) /g,5 -~{~-~}- acres <br />3 .2 Total acreage in Permit area ~/ ~ <br />4 ~.~ acres <br />4. Fees: <br />4 .1 New Application _$1,875.00 application fee <br />4 .2 New Quarry Application __$2 ,325.00 quarry application <br />4 .3 Milling Application (Non-DMO) $3, 100.00 milling application <br />4 .4 Amendment Fee $1,550.00 amendment fee <br />4 .5 Conversion to 112 operation (set by statute) $1,875.00 conversion fee <br />5. Primary commoditie(s) to be mined: Gravel Sand <br />5 .1 Incidental commoditie(s) to be mined: 1.UnknOwn - lbs/Tons/vr <br /> 2. / lbs/Tons/vr 3. / lbs/Tons/yr <br /> 9. / lbs/Tons/yr 5. / lbs/Tons/vr <br />5. 2 Anticipated end use of primary commoditie(s) to be mined:ROad building Alaterial <br />5. 3 Anticipated end use of incidental commoditie(s) to be m ined: Road Buildir.P Materia <br /> <br />