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STATE OF COLORADO <br />DIV1510N OF MINERALS AND GEOLOGY ~/' <br />Department of Neural Resource e1 /r E <br />1313 Sherman SL, Room2i5 ~~ ~ CEsVcp COLORADO <br />Denver, Colorado 60203 G DIVISION O F <br />%,ear (303) 8643567 ~ /'j\ coNSTRIICTION MATE1tiAIS// MAY 16 ?0 I N FORA L S <br />FAX: (30316328106 G v gEGUI,AR (112) OPERATION ~ G E O L O G Y <br />QI ~I ) EECLANATION•NININO <br />RECI.AMATIONPE1tMTfAPPLICATIONF~~Mmtrefca.,~.. sAreTr•sclENCs <br />- Bill Oweiu <br />- Gavemor <br />CHECK ONE: _~~ There V a File Number Alrsady Asalgned to Uds Operation <br />' ~- Russell Gtorae <br />Permit # ~-~~j~-mil "(rletse reference the Ste number ctareutly assignai to this operation} F,renne arECe. <br />New ltoatioa ule 1.4,5 Amendment lication ule 1.10 Rend w. ~aa+m <br />- APP ~ ~ ) APP (R ) Dwtswn Director <br />_~ COnvlrsbn Apphcation (Rule 1.11 } Natural Resource Tnatee <br />Pelmrt (! _Iv~- _T _ _ (pronde for Amendments and Convenioos of exrstmg Permits) <br />The applicatiaD for a Cottstructian Materials Regular 112 OperationReclametion Permit contains three majorpeAs: (t) the application form; <br />(2) Exhibits A-S, Addendtmm 1, any stations ofExhibit 6.5 (Oeotecbnical Stability Exhibit; and (3) the applicatiart fx. When you sobmityasv <br />application, be sure to i~ltrde o~ (1) complete sipped end notarized ORIGINAL end one (1) eopyof the completed applieationfarm, twD (2} <br />copies ofExhlbits A-S, Addendum 1, appropriate sxtioas of 6.5 (Geotechnical Stability Exhibit, and a checkfor the application fee descn'bed <br />under Section (4) below. Exlnbits should~~ be bound or in a 3-ring binder, maps should be foldedto 812" X 11' or 812' X 14"size. To <br />~P~k P~~~B. Please provide the iufoamation in the format and order described in tbis form. <br />GENERAI.OPERATIONINFORMATION <br />Type or print clearly, is Use apaee provided, AI,I hdormaUoa requested behw-. <br />r+~ <br />1. AHplkanUocersttor or comaanvname (Hama to be pant on Hermit): ~ s) C c~ ~ ~ r}~u,. ~ri ., ~- <br />1.1 Type of organization (corporation. partnership, etc.); ~a~ ~ Ro r~ a d ~i r . a ~~ <br />,/ ~ <br />2. ODeration name (pk, mine or sit! Hamel: N i ~ K2 ~ ~ ~~cult ~ I' ~ <br />3. Permkted acreage (new or e:istin[ site): ~ , `f Z permitted acres <br />3.1 Change in acreage (+) ~ ,7 ~~ j 3 acres <br />3.2 ToW acreage in Permit area (o-1.45 acres <br />4. ~: <br />4.1 New Application _SZ.344.00 application fee <br />4.2 New Quarry Application 52.906.00 quarry application <br />4.4 AmeDdmentFee SI.938.00 tfee <br />4.5 Conversion to 112 operation (set by statute) 52.344.00 conversion fee <br />5. Prlmarv eommodkk(aLto be mined: c ~ :tC\ lJ b-~ WLdYe aK. d Or1~ <br />5.1 Incidental commoditie(s) to be mined: 1. ~(01/ ti ]bs/Tons/vr 2. / ibs/ToDShr <br />3. / lbs/1'oDShr 4. / ~I7bslTons/vr n 15. / Ibs/fons/vr <br />5.2 AnttCrpated end use Of pnmary commoditie(S) to be ID1D[d: 1~1L'~!t a ~ ! r\ ;.,,,,,M i~C)2d C <br />5.3 Anticipated eDd use of incidental commoditie(s) to be mined n1 o rl I. <br />OfRce d Office of Colorado <br />