2003-06-26_REVISION - M1988057

• Permit No: M1988057
• IBM Index Class Name: Revision
• Doc Date: 6/26/2003
• Doc Name: Submittal
• From: Canyon Sand & Gravel
• To: DMG
• Type & Sequence: AM1
• Media Type: D
• Archive: No

~~~
Suhm~IFa'( v
~~~~~ OF COLORADO
DIVISION OF MINERALS AND GEOL04~'
Department o(Natural Resources
R E C E~ V C®
C
1313 Sherman SL, Room 215 ~
Denver, Colorado 80203 JUN
S

Phone: [phone] 61003/ M 1 N
E RA L S
FAX: [phone]?-8106 &
Division ~f Minerals and Geology G E O L O G Y
RECLAMATION
MININ G•SAf ETY
FILE
fOR
COPY
CONSTRUCTION MATERIALS
Bill Owens
Governor
CHECK ONE:
SCANN/NG SITED IMPACT (110) OPERATION '-
RECL~IMATION PERMIT APPLICATION FORM
New Application (Rule 1.4)
Greg E. Watcher
Executive Director
Michael B. Long
Division Director
Conversion Application (Rule 1.1 I )
_~ Amendment Application(C.RS.34-32.5-110)~c{u~(~4~ U.t( (4:t~5 ap~
,, J
Permit # M -~-~_ (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit wntains three major parts: (1) the application form;
(2) Exhibits A-], Exlu'bitL, Addendum 1, arty sections ofExhibit 6.5 and Geotechniral Stability Exhibit, as required by the Office, and outlined in Rules
6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be sure to include one (1) comolete signed and
notarized IVORY ORIGINAL and one (1) copy ofthe completed Ivory application font, two (2) copies of Exhibits A-J, Exhibit L, Addendum,), and
appropriate sections of 6S (Geotechnical Stability Exhibit), as required, and a check for the application fee described under (4) below. Exhibits should
NOT be bound or in a 3-ring binder, maps should be folded to 81/Z" X 11" or 8 12" X 14" size: To expedite processing, please provide the infotmation
in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or print clearly, io the space provided, ALL information described below.
1. A~plicsnUoperator or company Dame (name to be used on permit): ~6e~~ S
1.1 Type of organization (corporation, partnership, etc.): qq~~// 2`~4 ~/
1.2 I.R.S. Tax ID No. or Social Security Number. ftd (SJ !~ . O"f - (.J'r'r- / ~'~
2. Operation name (pit, mine or site name): ~GLilUf~rl ~1an Qnd Gf'~t~e.~
3. Permitted acreage (new or existing site):
3.1 Change in acreage (+)
Total Acreage in Permit Area
4. Fees:
4.1 New Application:
Amendment Fee (C.R.S. 34-32.5-125(II)):
4:2 Conversion Fee (from 1 l Od to l 10 875.00 conversion fee (Rule 1.11.2(2))
5. Primary commoditie(s) to be mined: x ~ r ra1~NMA~rl4r.l
~_ permitted acres
~' ~t~'C acres
w
~_ acres
$87®5.00 application fee
~ J aPPlication fee
~l$t3.
5.1 Incidental commoditie(s) to be mined: 1. / Ibs(fons/vr 2. / Ibsri ons/vr 3. / Ibs/fons/vr
4. / lbs?ons/vr 5. / IbE
5.2 Anticipated end use of primary commoditie(s) to be mined:
5.3 Anticipated end use of incidental commoditie(s) to be mined