_REVISION - M1981302 ‎(86)‎

• Permit No: M1981302
• IBM Index Class Name: Revision
• Doc Name: CONSTRUCTION MATERIALS REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM2
• Media Type: D
• Archive: No

IIIIIIIIIIIIIIII ,
t yr C70LORADO
DIVISION OF MINERALS AND GEOLOGY
Department ofNatural Resources
1 373 Sherman
St.. Room 215
Denver,Colorado 80203 ,—n_
Phone:[phone]
FAX:[phone]
7 EPAR17NF11I OF
°� ATURAL
CONSTRUCTION MATERIALS RESOURCES
REGULAR OPERATION (112) ,
RECLAMATION PERMIT APPLICATION FORM Roy RomerGovernor
N—L lames 5.Ezecurive Dinxtm Direct«
Q[�q Michael B.Long
-r •/ Division Duector
2MCR ONE: New Application (Rule 1.4.5) X Amendment Application (Rule 1.10)
Conversion Application (Rule 1.11)
Permit # tT- 81 - 302 (provide for Amendments and Conversions of
existing permits)
The application for a Regular 112 Operation Reclamation Permit contains three major parts: (1)
:he application form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical
Stability Exhibit; and (3) the application fee. When you submit your application, be sure to
include one (1) complete signed and notarized IVORY ORIGINAL and four (4) copies of the completed
ivy application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5
(Geotechnical Stability Exhibit, and a check for the application fee described under Section (4)
below. Exhibits should not be bound or in a 3-ring binder; maps should be folded to 8 2/2" X 11"
or 8 1/2" 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 the information requested below.
1. Applicant/operator or company name (name to be used on permit) :
Western Mobile, Boulder
1.1 Type of organization (corporation, partnership, etc. ): corporation
1.2 I.R.S. Tax I.D. No. or Social Security Number: 8y- 111615c)
2. Operation name (pit, mine or site name) : Deepe Pit
3. Permitted acreage (new or existing site) 195 permitted acres
3.1 Change in acreage (+ or -) acres
3.2 Total acreage in Permit area 195 acres
4. Fees:
4.1 New Application S1,875,00 application fee
4.2 New Quarry Application S2,325.00 quarry application
4.3 Milling Application (Non-DMO) S3,100.00 milling application
4.4 Amendment Fee $1,:400.00 amendment fee
4.5 Conversion to 112 operation (set by statute) $1,875.00 conversion fee
5. Primary commoditie(s) to be mined: NA
5.1 Incidental commoditie(s) to be mined: 1. NA - lbs/Tonslyr
2. / lbs/Tons/vr 3. / lbs/Tons/yr
4. / lbs/Tons/yr S. / lbs/Tons/yr
5.2 Anticipated end use of primary commoditie(s) to be mined: NA
5.3 Anticipated end use of incidental commoditie(s) to be mined: NA