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TATE OF COLORADO <br />D1V45{ON OF MINERALS AIVD GEOLOGY <br />Department of Natural Resources <br />1373 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: D031866-3567 <br />FAX: 13031832-8706 <br />CONSTRIICTION MATER[AZS <br />REGIILAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION BORM <br />CHECK ONE: There k a FIIeNtmrbcrAlready Aaalgned to tbfa Operation <br />Permit # _ v~I '_ ~ _ (Please reference the Sle>romber ca[xeatly assigved to dnv operation) <br />New Application (Role 1.45) _ Amendment Application (Rule 1.10) <br />Converoion Application (Role 1.11) <br />Permit # ,~_-~-,~_-d~ (provide fitt•Ameadmenta and Convereiom ofcaistmg Pe~dg) <br />D IY{SION OF <br />MINERALS <br />GEOLOGY <br />RE GIAIi ATION <br />tt[NING•s AFETY <br />Bill Owens <br />Governor <br />Greg E Watcher <br />E%etutive Diregor <br />Rawld w. Cottony <br />Actiry( Division Directs <br />The application for s CamshnctioaMaterial4 Regular 112 Operation ReclamatiomPetmit ovntains three majorpatb: (1) the application farm; <br />(Z) Exhibits A•S, Addendum i, aary sections of Fa[hrlri[ 65 (Geotechaical Stability Exhrbit; s~ (3) &e app&cation fee. When yon submit your <br />application, be sure ro iachrde one (1) ~k~c syRaed aadnota[vxd IVORY ORIGIlYAL and ~e (1) copy of the comple0ed Ley applica6ion <br />form, two (2) copies ofFadubits AS, Addendum 1, appropriate seclians of 6S (Geotechnical StabildyExhrbiy cod a tdteck for the application <br />fee descnbed nude[ Suction (4) below. Exhibits should NOT be bolmd or m:3-ring bradel; maps should befolded ro 812" X 11" or 8 I/2" <br />X 14" siu. To expedite processing, please provide the iafo~ation in lire fomut and orderdevcabud in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the apace provided, A.I.L Information requested below. <br />I. Aoalicsntlatxrator or comnanv aeme(nametu be used oa nermltl: ~~r~'i~~ (-n Ip {' _c~ t. {q}-~_ <br />I.l Type of orgarozation (corporation, partnership, etc.): C b t,,,,,,,~ J <br />1.2 LRS. Tax I.D. No. or Social Security Number. <br />1 z. <br />1 3. <br />y, ~ t 1 t il~ <br />Ooerafion name (Dir. mme or aRe name}: f V 1 Gh. C~ t_~iy v~ t;-rd,.~ v . 1 f • <br />Permitted acreage (Dew or e~tlnE site?: C] r. 9 permitted acres <br />3,1 Change in acreage (+) y0 , U acres <br />3.Z Total acreage in Permit area ~9~ acres <br />4. ~: <br />4.I New Application $2.344.00 appficationfee <br />4.2 New Quarry Application X52.906.00 gvarryappfication <br />4.4 Amendment tee S 1.938.00 amendmea[ few <br />d3 Conversion ro 112 operation (setby statute) $234d.00 conversion fee <br />i. Prim ary eoanuadltie;(a) to he mhred: e. l `r h <br />5.1 Incidental commoditie(s) to be nvned: I. (t.r~,' -~l tbU 1bJ1'onslvr 2. 17: r>- 1 aOCrU1 6sJTons/vr <br /> 3. / Ibs/1'onshr 4. / lbslTons/v: 5. ! 1 bsJTons/vr <br />5.2 Anticipated end use of primary commaddie(s) to be mined: .70 /~~ <br />5.3 Anticipated end vse of mcadentai c~moditk(sj to be mmod: ~6 !4 <br />