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<br />~: <br />~r~- i ~ <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources RECEIVED <br />1313 Sherman St., Room 215 o t v t s t o N o f <br />Denver, Colorado 80203 /APR 0 4 2003 MINERAL S <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 6c <br />Division of Minerals and Geelo G E O L O G Y <br />9y RECLAMATION <br />CONSTRUCTION MATERIALS MINING • S A F E T Y <br />REGULAR (112) OPERATION <br />Bill Owens <br />RECLAMATION PERMIT APPLICATION FORM ~ covemor <br />Greg E. Walther <br />Executive Director <br />CHECK ONE: There m a Ft7e Number Already Assigned to this Operation Ronald W. Cattany <br />Permit # M -_ _ _ (Please reference the Ells number currently assigned to this operation) Acting Division Director <br />New Application (Rule 1.4.5) x Amendment Application (Rule 1.10) <br />,Conversion Q,ppGcation (Rule 1.11) <br />Permit # M 2 0 _ O l _ 09 0 (provide for Amendments and Conversions of existing permiU) <br />The application for a Cansttuction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendtnn ],airy sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sme to inchule one (1) complete s~ned and notarized IVORY ORIGINAL and one (1) copy of the completed IV-d13' application <br />form, two (2) copies of Exhibits A-S, Addendum I, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application <br />fee descn'bed under Section (4) below. Exhibits should NOT be bound or m a 3-ring binder; maps should be folded to 8 1/2" X 11" or 8 1/2" <br />X 14" size. To expedite processing, please provide the information in the format and order descnbed in this form. <br />Gb'NER.SL OPERATION INFORMATION <br />Type or print ckaHy, in the space provided, ALL information requested below. <br />1. ApplicanUoperator or company name (name to be used on permill: Lafarge West, Inc. '~ <br />].1 Type of organization (corporatiop, partnership, etc.): Corporation <br />1.2 I.RS. Tax I.D. No. or Social Security Number: <br />2. Operation name (nit, mipe or site unmet: River Valley Resource <br />3. Permitted acreage (new oc esistine sitel: 105.41 pemined ages <br />3.1 Change in acreage (+) 22.85 acres <br />3.2 Total acreaez'v1Per> v~£ ,erea 128.26 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 $1.938A0 amendmeacfez <br />4S Conversion to 112 operation (set by statute) 52.314.00 conversion fee <br />~. Primary commoditie(sl to be mined: sand gravel <br />5.1 Incidental commoditie(s) [o be mined: 1. n/a - Ibsllonsfvr 2. / Ibs/Tons/vr <br /> 3. / lbs/Tons/vr 4. 1 lbs/Tons/vr 5. / lbsffonshr. <br />5.2 Anticipated end t>se of primary commoditie(s) to be mined: construction materials <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: n/a <br />