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TATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ~EP~VEFi ®FFICE <br />Department of Natural Resources ~h pf~~8p+ L'~B le f'~®~~ <br />4.g D1 1V !' 6.G ~o Received <br />1313 Sherman St., Room 215 p <br />Denver, Colorado 80203 ~rP~ ~i{8: !~~ ~ "l '~ I q <br />Phone: ( ~° iP,~ ~h8: 37 ~ />1 ~7fAU2~ Pf ~ uu~Aty <br />FAX: (30~`4~ ~ ~-~ 1"IFS 1 ~ 6 <br />2002 '~Qn011~ °~ <br />MAy 2D CONSTRUCTION MATERIALS 6tarxlJtamc~tePt,~{~ <br />REGULAR (112) OPERATION f ~ ~ ~ <br />pivision of Minezals and Georo9V <br />RECLAMATION PERMIT APPLICATION FORM <br />DIVISION OF <br />MINERALS <br />GEOLOGY <br />0.EC CA MATION <br />MINING•SA FETY <br />Bill Owens <br />Governor <br />Greg E. Walther <br />. / Executive Director <br />CHECK ONE: _ New Application (Rule 1.4.5) "Amendment Application (Rule 1.1I~ ichael e. Long <br />Division Director <br />_ Conversion Application (Rule 1.11) <br />Permit # M -~~- $ 5 -~ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Ivia[edals Regulaz 112 Operaflon Reclamation Permit contains three major pazts: (1) [he application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stabi]ityExhibit; and (3) the applicafion fee. When you submit your <br />application, be sure to include one (1) complete si¢ned and notazized 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 StabilityExhibi[, and a check for the <br />applicaton fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" <br />or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />1. AppGcant/operator or company name (name to be used on permit): ~QP'KE~oN CO1J5T(Z q Cg--l OiJ i rr 1. <br />1.1 Type oforganizafion(corporation,paztnership,etc.): CpJL~P.QsTi~N <br />1.2 LR.S. Tax LD. No. or Social Security Number: 8 ~ ~ Og7fP51 Z <br />2. Operation name (pit, mine or site name): '~ 2 R ~~ 9 ~zeaU E lr <br />3. Permitted acreage (new or existing 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(s) to be mined: C~,~/1V E L <br />5.1 Incidental commodite(s) to be mined: 1. N ~ - 1bslTons/vr <br />T <br />33 r 3 permitted acres <br />z5• ~ acres <br />S 8 • ~ acres <br />$2.344.00 application fee <br />2 00 quazry application <br />$1938.00 amendment fee <br />$2.344.00 conversion fee <br />2. / lbs/I'ons/vr <br />3. / Ibsll'ons/vr 4. / lbs/I'ons/vrA' S. / lbs/Tons/vr <br />5.2 Anficipated end use of primazycommodifle(s) to be mined: Ro~~ tLwSE <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: ~ A <br />