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STATE OF COLORADO <br />DIVISION Of RECLAMATION, MINING ANO SAFETY <br />,t n _[ <br />Department of Natural Resources ~ <br />/ ~/ I `ff!'1 <br />1313 Sherman St., Raom 275 <br />C O L O R A D O <br />Denver, Colorado 80203 <br />Phone: {303) 866-3557 <br />RE~ D I v 15 1 o N o r <br />L N <br />N <br />FAx: (303) 832.8706 <br />~1VE <br />MI <br />NG <br /> NOV 0 71001 snFErY <br /> <br /> CONSTRIiCTION;VIATERIALS Division of Recla <br /> matiorpiu Ritter, tr. <br />Mining and Saf <br /> efy <br />LIMITED IMPACT (110) OPERATION cnvemnr <br />RECLAMATION PERMIT APPLICATION FORM Hams o. Sherman <br />Executive DlreClor <br />Ronald W. Canany <br />Division Director <br />CHECK ONE: X There is a File Number Already Assigned to this Operation lJatuai Rewurce trustee <br />Pemrit # M - 199 - 027 __ (please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4.5) X Amendment Applicaton (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M - 1997 - 027 __ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Limited Intact (1 l0) Opemtioa Reclamation Permit contains three major parts: (I) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendtun 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required <br />by the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.20)(6); and (3) the application fee. When you submit your application, be <br />sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies <br />of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geoteehnical Stability Exhibit), as required, and a check for <br />the application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8112" X <br />11" or 8 l/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 described below. <br />AHHiicant/ooerator or rnmoanv name (name to be used on Hermit): A.J Botti Construction 8 Gravel <br />1.1 Type of organization (corporation, partnership, etc.): Sole proprietor <br />2. Otxration name (oit, mine or site name): Moonscape Pit <br />3. Permitted acreaee (new or eaistina site): 6.99 permitted acres <br />3,1 G7eange in acreage (+) 0.57 acres <br />3.2 Total Acreage in Permit Area 7.56 acres <br />4. Fees: <br />4. t New Application: 1 25$.00 application fee <br />Att~ttdirtent Fee (C.R.S. 34-32.5-t25(II)): -5827.00 application fee <br />4.2 Conversion Fee (from 1 i0d to I10 ~1,258.8o conversion fea (Rule i.t 1.2(2)} <br />5. Primary commoditie(s) to be mined; Sand Gravel Soils <br />5.1 Incidental commoditie(s) to be mined: I. ! Ibstfons/vr 2. ! Ibs/Tons/vr 3. 1 lbs/Tons/vr <br />4. / IbstTons/vr 5. / IbslTonslvr <br />5.2 Anticipated end use of primary cotmoditie(s) to be mined: Roadbase/Fill <br />Anticipated end use of incidental commoditie(s) to be mined: N/A <br />Office of Office of <br />AAinad 1 and Rn~lamatinn f)envnr • f :ranri lunrtirxt • nuranan aniva and Inarfivo Minn. <br />