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<br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 ~ ~~ ,~~ D 1 v 1 S I o N o f <br />Phone: (303) 866-3567 ~~j~ ~,,.t, /YI ~ ('p ~:~C~~ MINERAL 5 <br />FAX: (303) 832-8106 U - Sc <br />RECEIVED 9 903 ~'-~~~- RECEIVEi~ GEC°„° oN <br />CONSTRUCTION MA~I'EBIAIS MINING • S A F E T Y <br />SEP t ,~ 2003 REGULAR (112) OPERATION SEP 101003 <br />Bill Owens <br />l RECLAMATION PERMIT APPLICATION FORII~ GOVemor <br />Division of Minerals and Geolo®y .vision of nninerals ar;d Gaola~y~ E. Walther <br />Executive Director <br />CHECK ONE: x There is a Frle Number Already Assigned to this Operation <br />Ronald W. Caaany <br />Permit # M -'2caj - ob0 __ (P]ease reference the file nmmber currently assigned to this operation) '~'"g Division Director <br />New Application (Rule 1.4.5) _ Amendment Application (Rule 1.10) <br />X Conversion Application (Rule 1.11) <br />Permit # M - zoo t -~-_ (provide far Amendme~s and COtrieraions of wi ~a Permits) <br />The application for a Constricfian Materials Regrdar 112 Operation Reclamation Pe~R oamtams tlttee major pmts: (1) the application form; <br />(2) Exhibits A-S, Addendmm 1, any sections of Exhibit 65 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />applicalioq be sure to include time (1) complete siffied and notarized IVORY ORIGINAL and tine (1) copy of the completed IV IV application <br />form, two (2) copies ofExhtbits A-S, Addeudnm 1, appropriate swtitms of 6.5 (Geotecltnical Stability Exhibit, and a check for the application <br />fee descnbed under Section (4) below. Exhibits should NOT lle bound or in a 3-ring binder; maps should be folded to 812" X 11" or 8 1/2" <br />X 14" size. To expedite processing, Please provide the infmmaeoa ro the format and order descnbed in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, to the apace provided, ALLmformation requested below. <br />1. Apolicant/onerator or comoanv mane (name to be need on oermitl: 3 3 c r+Ta_"'2 P 2ZS ES r t_. L c <br />].1 Type of orgasm'?fi^n (corporation, PaxlnersltiP, etc•): L-t- ~ <br />1.2 I.R.S. Tax I.D. No. or Sociai Severity Nunber: <br />2. ODeratioe name (nit, mine or ske Hamel: <br />~ c gal'-L.~ 5 T'L T <br />3. Permitted acreatte (new or eSlatmo sftel: <br />3.1 Cbangein acreage (~) <br />3.2 Total acreaee in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />45 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: ~i 2A v c-l_ Sp, rl `~ _ <br />r=SL ~- <br />5.1 Incidental commoditie(s) to be mined: 1. ryR r - I ocC Ibs/Tons/vr <br />9.99 permittedaaes <br />1 3 • b acres <br />2 3 . 59 acres <br /> <br />52.344A0 application fee <br />52.906.00 gttarry application <br />SI.938.00 amendmeatfec <br />52.3.14.00 conversion fee <br />2. / Ibs/Tons/vr <br />3. / Ibs/I'onshr 4. / lbs/Tonslvr 5. / 1bsrTons/vr <br />5.2 Anticipated end rue of primary commoditie(s) to be mined: ~ ~ •~ s ~ "- ~ ~ rsc..; Il'1 w ~-,zr,4 L <br />5.3 Anticipated end Ilse of incidental commoditie(s) to be tniaed: Cbi` S ' "" ~ ` rO ^' t'1'4 ~~~- A L- <br />