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STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY RECE9VED <br />Department of Natural Resources - <br />1313 Sherman SL, Room 215 FEB 01 2002 <br />Denver, Colorado 80203 D I v I s I O N o f <br />Phone: (303) 866-3567 ~ M I N E R:~ I. $ . <br />FAX: (303) 832-8106 Division of Minerals and Geology G E ~ L ~ G Y <br />CONSTRUCTION MATERIALS R E C L A M A T I O N <br />MINING•gAFETY <br />REGULAR (112) OPERATION ' <br />RECLAMATION PERMIT APPLICATION FORM Rill Owens <br />Governor <br />' Greg E. Walther <br />,- - Executive Director <br />CHECK ONE: _ New Application (Rule 1.4.5) ,~~_ Amendment Application (Rule 1.1 icnaei R. Long. <br />- ~ivision Director <br />Conversion Application (Rule 1.11) <br />Permit # M - 76 - 020-_ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction IvIatedals Regulaz 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendtmt 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When yvu submit your <br />applicafion, be sure to include one (1) complete sieved 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 (Geotechnicai Stability ExtilbiG and a check for the . <br />applicaton fee described under Section (4) below. Exhibits should NOT b8 bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" <br />or 8 lYl" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print cleazly, in the space provided, ALL information requested below. <br />1. Applicantloperator of company name (name to be used on permit): Oldcastle SW Group, Inc. <br />1.1 Type of organization (corporation, paz[nership, etc.): Corporation <br />1.2 LR.S. Tax LD. No. or Social SeclnityNumber: 84-0449536 <br />2, Operation name (pit. mine or site name): <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 />Thomas Pit <br />29. R permitted acres <br />10-9R acres <br />LD. 7R acres <br />4.1 New Application $2.344.00 application fee <br />4.2 New Quarry Application $2.906.00 quarry application <br />4.4 Amendment Fee $1.938.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) $2.344.00 conversion fee <br />5. Prunarv commoditie(s) to be mined: Gravel <br />5.1 Incidental commoditie(s) to be mined: 1. lbs/I'ons/vr 2. / 1bsR'ons/fir <br />3. / lbs/Tons/kr 4. / lbs~i'ons/vr 5. / lbs/I'ons/Kr <br />5.2 Anticipated end use ofprimazycommoditie(s)tobemined: Aggregate for concrete and-road gravel <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />