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IVISION OF MINERALS AND GEOLOGY <br />Department of Nazuml Resources <br />1313 Sherman St. Room 215 <br />Drnveq Colorado 80203 Phone: <br />Phone (303) 866-3567 FflX: <br />Fax: (303)SI2-8106 <br /> <br />Dtuision of Minerals and Geology <br />~u~ ~ ~ aoo1 <br />CONSTRUCTION MATERIAL <br />REGULAR 112 OPEPRATION <br />RECLAMATION PERMIT APPLICATION PACKAGE <br />CHECK ONE: New Application (Rule 1.4.5) <br />XX Conversion Application (Rule I.11) <br />CxEOLOG <br />Bill Owens <br />Governor <br />Geg E. Wdcher <br />Exewtive Director <br />Michael B. Long <br />Division Dvectar <br />Amendment Application (Rule 1.10) <br />Permit # M - 79 - 058 - (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regulaz 112 Operation Reclamation Permit contains three major parts: (I) the application form; (2) <br />Exhibits A-S, Addendum I, 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 (1) complete sieved and notarized IVORY ORIGINAL and four (4) copies of the completed Ivory application <br />form, five (5) copies of Exhibits A-S, Addendum I, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for [he application fee <br />described under Section (4) below. Exhibits should _ be bound or in a 3-ring binder; maps should be folded to 8 112" X 11" or 8 112" X 14" size. To <br />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 />Applicant / operator or company name (name to be used on Dermitl: Routt County <br />1.1 Tvpe of organization (corporation, partnership, etc.): Government <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: <br />2. Operation Name fPit. mine or site name): Funk Gravel Pit, Routt Counlv Pit # Sll <br />3. Permitted acreage (new or existing site) 8.J Permitted Acres <br />3.1 Change in acreage (+) 39.2 Acres <br />3.2 Total acreage in Permit area 47.6 Aaes <br />4. FEES: <br />4.1 New Application 1 875.00 appOcation tee <br />4.2 New Quarry Application ~ 2$ 325 00 quarry apphcnpon <br />4.3 Milling Application (Non-DMO) 3 100.00 mining application <br />4.4 Amrndmen[ Fee 1 510.00 amendment tee <br />4.5 Conversion to 112 operation (set by statute) 1875.00 conversion fee <br />5. Primary eommodide(s) [o be mined: Gravel <br />5.1 Incidental commoditie(s) [o be mined: I. Gravel - 60.000 Ibs on yr 2. - Ibsfronslvr <br />3. Ibs/Tons/vr 4. Ibs/Cons/vr 5. Ibs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Road Construction and Maintenance <br />5.3 Anticipated end use of incidental commoditie(s) t0 be mined: Road Constmc[ion and Maintenance <br />