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f coLOr~o <br />D!V!SlON OF MINERALS AND GEOLOGY APR 0 8 2005 / <br />GeparUnent of Natural Resources <br />1313 Sherman St, Room 215 - - C O L O RAD O <br />Denver, Coorado 602D3 Division of Minerals and Ge-olo~~ee~ D I V I S I O N O F <br />Phor~ (303) 866.356) CONSTRIICiTON MATEBiALT , q~~5 . MINERAL S <br />FAX: (303) 832.8106 REGIII.e1R (111] OPERATION ~ ~~' O J ~ O Ii O Ls G <br />RECI,AMATIONPERNIITAPPLICATIONFORM Irr,~{`'110"r°IS&,~rtrti RE fAEET1'!fC1ENrCENG <br />.1911 ' <br />Bill Owens " <br />HECK ONE: There is a File Nnmher Already Asslgaed to this Operation c~nw <br />Rueell George <br />Permit # v~-~-~ ~` (Plea~c lefes~ce the fiYe number cvtxently assignedto tlris operation) ~ecw"e oimrror <br />i New Application (Rule 1.4.5) ~ Am~dment Application (Rule I.10} Ronald w. Ultarry <br />Division Director <br />Conversloa Application (Rltle 1.11) r'lanrral Resource 7aarcr <br />Permit# ~uI_-_,(~-~"~ -/TI (pravidefarAmmdmmbandCwiversbasofexistmg Paaoits) <br />Ile application for a COashuction Materials Regular 112 OpecationRxlamstionPemritcontaias threenlaj~ paAs: (1) t)ffi application frnm; <br />1}ExhlbitsA-S,Addeuduml,atryseclionsofExhtlrit6.5(Gaoler)mical3tabilityElcLibi~and(3}iheappflcationfee. Wheayousub~mityaa <br />pplication, be suEeto include ~ (1) tbmolete signed and untamed ORIGINAL and erne (1) copyOf the completed app]iEatiinnfam,two (2) <br />bpies ofExhlbits A-S, Addeudnm 1, appropriate sections af6.5 (t.~eoteclmical StabitilyF.xlubit, sad acheck far t1~ epplicati~ fee dasmbed <br />ItderSectmn(4)below. Exhlbitsshopld T~O~bebamd~in83-riagbinda;mapsshwlidbefoldedto812°X11"or8ll2"X14"size TO <br />xpedite processing, please provide the infaamation in the format and order deacdbedm his form <br />Alva - ~ <br />lr'L'NERAI, OPERATION IIdFORMAITON ~^ p ~1 , / ~ <br />Type or print clearly, in the space Provided, ALL intormationrequested//helRw. nn p, `- /~C.Y~`' (4 1 <br />Applkanfloperator or oompsnv Hanle (name to 6e geed on~,peralit); ~~~~ ~/~ftrrlC (dm,o2~tei r~ <br />I.1 Type of organization (eorporatian, parateaship, etc.}:,~f~ y.~' jJ o R~l'7/e~rL~ <br />1.2 I.R.S. Tax LD. No. or Social Securitq Number: cQT - ~Oo°1 /T~o(i <br />Operation name foil, ali~ or site name): <br />PermNted acreage four or a 'atia~a sibe): <br />3.1 Change in acreage (+) <br />3.2 Total acaeage m Permit area <br />Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 AmendmentFce <br />4.5 Comeeon to ] 12 opaatiOn (set by statute) <br />Permitted acres <br />~~~aa~JD~~. ,7~y acres <br />~ arses <br />52344.00 application See <br />X2.906.00 quarry application <br />$1.938.00 amendment fee <br />52344.00 conv+etxiOnfre <br />Priman commoditie(s) to 6e mined: ,0„111 ~~~S~~J`~J~ <br />S.1 huadental ce®moditie(s) to be mined: I !1'Ddl~ Ibs/foxls/ar 2. / Ibs/Pons/vr <br />3. / ]bs/fans/~r 4. / Ihs/fon~r S. / Ibsfl'ops/vr <br />5.2 Alltieipated end use of praluny eommoditie(s) to be mined: C7C DOUG ~S <br />5.3 Anticipated end use of incidental commoditie(s) t4 be mined: _1 Y <br />Office of Office of Colorado <br />AAine,l I ~rv1 Rerl~matitm ~tiivn a.vi InaMive Minef r:n..l„nie-~I G~n.e.r <br />