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I1 ^E OF „;QQI�ADO <br /> DIVISION OF MINERALS AND GEOLOGY 999�II 1II�IfIII����«II� <br /> Department of Natuial Resources <br /> 1313 Sherman St.. Room 215 <br /> JUN 2 6 2001 <br /> Denver,Colorado 80203 D I V I S I O N O r <br /> Phone:(303)866-3567 CONSTRUCTION MATERIALS Division of Minerals and Geolo eI N E RA L 5 <br /> FAX:(303)83::-8106 REGULAR(112) OPERATION RECEIVE G E O L O G Y <br /> RECLAMATION PERMIT APPLICATION FORM RECLAMATION <br /> AUG J 1001 MINING-SAFETY <br /> l L ��'s <br /> Division of Minerals and <br /> CHECK ONE: There is a File Number Already Assigned to this Operation <br /> Greg E.Watcher <br /> Permit# M _— (Please reference the file number currently assigned to this operation) Executive Director <br /> M2hae1 8,Long <br /> New Application(Rule 1.4.5) _Amendment Application(Rule 1.10) Division Director <br /> _ Conversion Application(Rule 1.11) <br /> Permit# M --&?- cq'y (provide for Amendments and Conversions of existing permits) <br /> The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts:(1)the application form: <br /> (2)Exhibits A-S,Addendum 1,any sections of Exhibit 6.5(Geotechnical Stability Exhibit;and(3)the application fee. When you submit your <br /> application, be sun: to include one (1)complete si®ed 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 (Geotechaical Stability Exhibit,and a check for <br /> the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder, maps should be folded to <br /> 8 1/2"X I I"or 8 1/2"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 clearly,in the space provided,all information described below. <br /> I. Apo6cant/otaerator or comoanv name(name to be used on permit): <br /> 6via.vr CouurY <br /> 1.1 Type of organization(corporation,partnership,etc.): IS0VI`RA/111,5VT <br /> 1.2 I.R.S. Tax I.D.No. or Social Security Number: ��I�— 000— �9S <br /> _. Operation name(pit mine or site name): 04 K CIT cEk - GRAV64 101,7 <br /> 3. Permitted acrease(new or eiisthis site) ,• ^ permitted acres <br /> 3.1 Changc in acreage(+) -�- /ppG• acres <br /> 3.2 Total acreage in Permit area �3• acres <br /> 4. Fees: <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) V�$2.344.00 conversion fee <br /> 5. Primary cooamoditie(s)to be mined: GnAVEG <br /> 5.1 Incidental commoditie(s)to be mined: I. / Ibs/fons/vr 2. / Ibs/Tons/vr 3. / Ibs,/TonsAT <br /> 4. lbs/TonsA7T�5. Ibs/Tons/vr <br /> ry 5.2 Anticipated end use of prima commoditie(s)to be mined: / 040 1W4r7Z1AZ <br /> 5.3 Anticipated end use of incidental commoditie(s)to be mined: <br />