2002-03-27_REVISION - M1996076

• Permit No: M1996076
• IBM Index Class Name: Revision
• Doc Date: 3/27/2002
• Doc Name: Completeness
• From: Map Surveys Inc
• To: DMG
• Type & Sequence: CN1
• Media Type: D
• Archive: No

N~d~~~b`VIEI®
I ~ MAR 2 7 2002
Oiviaiort of fdinerah eBd fieology
STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
Department of Natural Resources
1313 Sherman St., Room 215 ~ ~ ~iy~~~~ j~~
Denver, Colorado 80203 II 1
Phone: [phone]
FAX: [phone]
DEPARTMF.Nf OF
CONSTRIICTI!IOR MATERIALS NATURAL
LIMITED II~ACT OPERATION (110) RES~IJRCES
RECE.nvn'rION PERMIT APPLICATION FORM RayROr,K,
GOVertgr
Jarrks 5. Lxhhead
Executive Director
. ~ Michael B. Long
Division Director
CHECK ONE: ~_ New Application (Rule 1.4] Amendmeat Application (C. R.S. 34-32.5-110)
Conversioa Application (Rule 1.11) _
Permit # - -_ (provide for Amendments and Conversions of
existing permits)
The application for a Construction Materials Limited Impact Mining (110) Operation Reclamation
Permit contains three major parts: (1) the application form; (2) Exhibits A-J and Exhibit L,
Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the
Office, and outlined in Rules 6.1, 6.2, 6.3, and 6.5; and (3) the application fee. When you
submit your application, be sure to include one (1) comHlete sioned and notarized IVORY ORIGINAL
and one (1) copy of the completed ivory application form, two (2) copies of Exhibits A-J and
Exhibit L, appropriate sections of 6.5 (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 8 1/2" X il" or 8 1/2" X 14" size. To expedite processing,
please provide the information in the fozmat and order described in this form.
-------------------------------------------------------------------------------------------
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, all information described below.
1. AHHlicantLoperator or company na~name to be used on Hermit)-
1.1 Type of organization (corporation, partnership, etc.): __ So% ~r'O~%'/t°7~0~"___
1.2 LR. S. Tax ID No. or Soeial security Number: .-; ~.3- .i~L? -,~ 9 ~ sI
2. Ooeration name (pit, mine or site name):
3. Permitted acreace (new or existing site):
3.1 Change in acreage (+ or -)
Total Acreage in Permit Area
4. Fees•
5.
,2
9~ SS permitted acres
-~ acres
9, 5S acres
4.1 New Application 5875.00 application fee
Amendment Fee,(C.R.S. 34-32.5-125(II)) 6575.00 ~ application fee
4.2 Conversion Fee (from 110d to 110 875.00 conversion fee (Rule 1.11.2(2))
Primary commoditie(s) to be mined: ~ L`1/"A/C~ ~ -
5.1 Incidental commoditie(s) to be mined: 1. l/11~2'~ - 75ZU %~Y lbs/Tons/vr _
2. / lbs/Tons/vr 3. / lbs/Tons/vr
4. / lbs/Tons/vr 5. / lbs/Tons/vr

5.2
Anticipated end use of primary commoditie(s) to be
mined:<rO /
ficn Coi7~Y0~^L~~SCd~~
5.3 Anticipated end use of incidental commoditie(s) to be mined: ~oete~ hart