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a • • <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1373 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />STATE OF COLORADO <br />RECEIyED ~~ <br />MAY 0 t 2001 <br />Division of Minerals and Geology <br />D i V I S 1 0 N O F <br />MINERALS <br />GEOLOGY <br />RECLAMATION <br />MINING•SAFETY <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: ~ New Application (Rule 1.4.5) <br />Conversion Application (Rule 1.11) <br />Bili Owens <br />Governor <br />Greg E. Walther <br />Executive Director <br />R Amendment Application (Rule 1.1 ¢hael B. Long <br />~ivision Director <br />Permit # M - 83 _ 00 _ 67 (provide for Amendments and Conversions of existing permits) <br />The application for a Construcfion Materials Regulaz 112 Operation Reclamation Permit contains three major pazts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any secfions of Exttibit 6.5 (Geotechnical StabilityExhibit and (3) the applicaflon fee. Wlten you submit your <br />application, be sure to include one (1) complete siened and notarized IVORY ORIGINAL and four (4) copies of the completed Ivorv <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a checkfar the <br />applicaflon fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" <br />or 8 lY2" 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 requested below. <br />~o i e remix oncre e, nc. a su sa. iary <br />1. AppGcantloperator or company name (name to be used on permit); of Lafarge North America Inc. <br />1.1 Type of organization (corporation, paztnership, etc.): Corporation <br />1.2 I.R.S. Tax I.D. No. or Social SecurityNumber: <br />2. Operation name (ait, mine or site name): Stagecoach Tline <br />3. Permitted acreage (new or existing site): 52 permitted acres <br />3.1 Change in acreage(+) 0 acres <br />3.2 Total acreage in Permit azea 52 acres <br />4. Fees <br />4.1 New Application $2.344.00 application fee <br />4.2 New Quarry Application $2.906.00 quarry applicaflon <br />4.4 Amendment Fee $1.938.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) $2 344.00 conversion fee <br /> Sand Gravel Shale <br />5. Primary commoditie(s) to be mined: <br />5.1 Incidental commodite(s} to be mined: 1. 500, 000 lbs/Tons/vr 2. / IbslTons/vr <br /> 3. / lbs/Tons/vr 4. / lbs/I'ons/vr 5. / lbs/Tons/vr <br />5.2 Anticipated end use ofprimazycommoditie(s)tobemined: Construction Aggregates <br />5.3 Anticipated end use of incidental commoditie(s)tobemined: Construction <br />