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,~ ~a37 <br />~l, 938, o0 <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ~iECEIVED <br />Department of Natural Resources enn~f <br />1313 Sherman St., Room 215 ~~~ : ' 2uu~ DIVISION O F <br />Denier, Colorado 80203 MIN .E R. A L $ <br />Ptwrre: (303) essass7 ~ division of Minerals and Gealagy & <br />Fnx: (303)e32-egos G E O L O G Y <br />CONSTRUCTIONriiATRRiAi.S / <br />REGULAR (112) OPERATION <br />RECLAMATION PERMTT APPLICATION FORM <br />CHECK ONE: _ New Application (Rule 1.4.5) X Amendment Application (Rule 1.10) <br />_ConversionApplica'on(Itulel.ll) <br />Pemut # M - 77 - 344 - (provide for Amendments and Conversions of existing permits) <br />0.EC LA NATION <br />MINING~SA FETY <br />Biu Owens <br />Governor <br />Greg E. Walcher <br />Executive Duec[or <br />IvGcitael B. Long <br />Division Director <br />The application for a Construction Materials Regular 112 Operation Reclamation Pemut contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geo[ecbnical Stability Exbibit); and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete signed and notarized IVORY ORIGINAL and four (4) copies of the completed Ivy <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geo[echnical Stability Exhibit), and a check for the <br />application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ling binder; maps should be folded W g 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. Aoolicant/ooerator or comoanv name (name to be used on oermitl: Holcim (iJSI Inc (formerly Holnam Inc 1 '~ <br />2. <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />1.2 LR.S. Tax LD. No. or Social Security Number: <br />3. Permitted acreage (new or ezisting site): <br />3.1 Change in acreage (+) <br />32 Total acreage in Pemvt 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: Limestone <br />5.1 Incidental commodities(s) to be mined: 1. sandstone/ 95.000 -lbs/Tons/vr <br />3. / Ibs/Tons/vr 4. / 16s/Tons/vr <br />1232 permitted acres <br />74 acres <br />1306 acres <br />$2344.00 application fee <br />$2,906.00 quarry application <br />$1.938.00 amendmen[fee <br />$2.344.00 conversion fee <br />2. / Ibs/Tons/vr <br />5. / Ibs/Tons/vr <br />52 Mticipated end use of primary commoditie(s) [o be mined: production of cement <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: production of cement <br />