2003-03-24_REVISION - M1978268 (2)

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TATE OF COLORADO DIVISION OF MINERALS AND GEOLOGY Department of Na}ural Resources MAR 2 42003 1313 Sherman St., Room 215 DIVISION O F Denver, Colorado 80203 MINERAL S Phone: (303) 8663687 Division of Minerals and Geolo~ECEr~e & FAX: (~gp~al~OpV G GEOLOGY FOR SCATT INN/NG CONSTRUCTION MATERIALS MAR 2 4 2003 M NCI N G 3 A F EOT Y REGULAR (112) OPERATION piyision of Minerals and (i8ig)~ns RECLAMATION PERMIT APPLICATION FORM Gov~~el~r Greg E. WaEher Executive Director CHECK ONE: New Application (Rule 1.4) _~ Amendment Application (Rule 1.10) Michael B. Long Division Director Conversion Application (Rule 1.11) Permit # M -1978 - 268 - 112 (Provide for Amendments and Conversions of existing permits) The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: O the application form; ® Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit) and ® the application fee. When you submit your application form, be sure to include one (1) complete siened and notarized IVORY ORIGINAL and four (4) copies of the completed Iv r application form, five (5) copies of Exhibits A-S, Addendum I, and appropriate sections of 6.5 (Creotechnical Stability Exhibit), and a check for the application Cee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder, maps should be folded to 8%:" x 11" or 8%:" x 14" size. To expedite processing, please provide the information in the format and order described in this form. GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, ALL information described below. 1, App licantJoperator or company name (name to be used on permiU: OURAY COUNTY ROAD s BRIDGE DEPARTMENT 1.1 Type of orginazation (Cocpomtion, partnership, etc.): COUNTY GOVERNMENT 1,2 I.R.S Tax ID. or 2. Ope ration name (pit, mine, or site name): DALLAS GRAVEL 3. Permitted Acreaee (new or exist): 18.35 permitted acres 3. ] Change in acreage (+) +27.57 acres 3.2 Total acreage in permit area 39.92 acres 4. Fees: 4.1 New Application: $2,344.00 appbcation fee 4.2 New Quarry Application $2 906.00 quarry application 4.4 Amendment Fee CHECK # 2 / / 03 tAtTacnEDl $1,938.00 amendment fee 4.5 Conversion Fee [0 112 operation (set by statute) $2,344.00 conversion fee 5. Primary commoditvL.ies) to be mined: SAND AND GRAVEL 5.1 Incidental commodity(..ies) to be mined: 1. / lbs/Ton/Yr 2. / Ib/Ton/Yr 3. / lbs/Tott/Tr 5.2 Anticipated end use of primary commodity(...ies) to be mined: ROCK AGGREGATE PRODUCTS 5.3 Anticipated end use of incidental commodity(...ies) [o be mined: