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~N - / <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />PAX: (303) 832-8106 <br />RECE <br />APR 2 4 2002 <br />CONSTRUCTION MATERIALS Division of Minerals and i <br />REGULAR (112) OPERATION ~ <br />DIVISION OF <br />MINERALS <br />GEOLOGY <br />R ECIAMATION <br />ithfrylNG•SAFETY <br />RECLAMATION PERMIT APPLICATION FORM Bill Owens <br />Governor <br />Greg E. Wakher <br />- Executive Director <br />CHECK ONE: _ New Application (Rule 1.4.5) _ Amendment Application (Rule 1.1 ichael B. Long <br />ivision Director <br />XX Conversion Application (Rule 1.11) <br />Permit # M - 197& 283-_ (provide for Amendments and Conversions of elds[ing permits) <br />The application for a Construction Materials Regulaz 112 Operation Reclamation Permit contains three major pazis: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geo[echnical StabilityExhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete siened and notarized IVORY ORIGINAL and four (4) copies of the completed Ivory <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical StabilityF~hibit, and a check for the <br />applicafion fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 lYl" X 11 " <br />or 8 1/2" X 14" size. To expedite processing, please provide the informafion 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/ouerator or company name (name to be used on permit): Walsenburg Sanrl k Graval ~ Tnr . <br />1.1 Type of organization (corpora[ion,paztnership,etcJ: Corporation <br />1.2 LR.S. Tax LD. No. or Social SecurityNutnber: <br />2. Operation name (pit, mine or site name): Sand Arroyo Pit / <br />3. Permitted acrea¢e (new or existine site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit azea <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(sl to be mined: Sand -6" Rock <br />. 5.1 Incidental commodite(s) to be mined: 1 None - lbs/Tons/vr <br />3. / lbs/'I'ons/vr 4. / lbs/I'ons/vr <br />g permitted acres <br />43 acres <br />52 acres <br />$2.344.00 application fee <br />$2.906.00 quarry application <br />38 amendment fee <br />2 344.0 conversion fee <br />2. / lbs/rons/vr <br />5. / lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: None <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: None <br />