Laserfiche WebLink
o~rz~~~ <br />RECEIVED <br />JAN t 3 2Q05 / <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />Division of Minerals and Geology <br />t~ <br /> <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Permit # M -198~F 022-_ (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4.5) <br />Conversion Applic ~ n (Rule 1.11) <br />X Amendment Application (Rule I.10) ' <br />Permit # M 1981 _ 022 __ (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 <br />form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure [o include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed <br />application Form, two (2) copies ofExhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and acheck 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 ]/2" X ] 1 " or 8 1/2" X ] 4" 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 requested below. <br />t. Aonlfcant/operator or comoanv name (name to be used on nermitl; Connell Resources. Inc. `~ <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />1.2 I.R.S. Tax [.D. No. or Social Security Number: <br />2. Oneratimt mm~e )pit, mine or site name): <br />3. Permitted acreaee (new ar existine site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4,2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute} <br />5. Primary commoditie(s) to be mined: Aggregate _ <br />5.1 Incidental commoditie(s) in be mined: 1. N/A- Ibs/Tons/vr <br />3. / lbs/Tons/vr 4. / lbs/Tons/vr <br /> <br />1 5.4 permitted acres <br />0 acres <br />15.4 acres <br />$2.344.00 application fee <br />$2,906.00 quarry application <br />$L938.00 amendment fee <br />$2.344.00 conversion fee <br />2. / Ibs/Tons/vr <br />5. / Ibs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Construction materials <br />5.3 Anticipated end use of incidemal commoditie(s) to be mined: N/A <br />