2003-12-09_REVISION - M1994118

• Permit No: M1994118
• IBM Index Class Name: Revision
• Doc Date: 12/9/2003
• Doc Name: Revised Amendment
• From: Fremont County
• To: CCEV
• Type & Sequence: AM1
• Media Type: D
• Archive: No

TPAFE OF COLORADO
DIVISION OF MINERAL$ AND GEOLOGY
Department o(Natural Resources
1317 Sherman St., Room 215
Denver, Colorado 80203
Phone: [phone]
FAX: [phone]
CONSTRUCTION MATERIALS
ILH~~1s t~i d IG 9>
DEC 0 ~ 200
LIMTCED IMPACT (110) OPERATIOPinII of dAinerala and Gealo9y
RECLAMATION PERMTf APPLICATION FORM
CHECK ONE: Y There is a File Number Already Assigned to this Operatiou
~~
DIVISION OF
MINERALS
GEOLOGY
0.EC LAMATION
MINING•SAFE TY
ain oven:
Governor
Greg E. Walther
Executive Direcor
Penni[ # M - \°J = y4- I1~ lease reference the file number current assi ed to this o erasion '~ichael 8. long
(P ly ~ p ) Division Director
`New Application (Rule 1.4.5) ~ Amendment Application (Rule I.10)
,Conversion Application (Rule 1.11)
Permit # M - \ 9 _9t} _ i 1 g (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the
application form; (2) Exhibits A-J, Exhibit I., Addendmn 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the
Office, and outlined in Roles 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be slue to
include one (1) complete siffied and notar¢ed IVORY ORIGINAL and one (1) copy of the carr~leted Ivory application form, two (2) copies
of Exhibits A-J, Exhibit L, Addendmm 1, and appropriate sections of 6.5 (Geotechnical S[abiliy Exhibit), as required, and a check for the
application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring binder, maps should be folded to 8 1/2" X 11" or
8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form.
GENERAL Ol?ERATION INFORMATION
Type or print clearly, in the space provided, AT.L information described bebw.
1. AonlicanUonerator or comoanv name (name to be used of
~2~n1 ot~r7 C'ouNZ1t
I.l Type of organization (corporation, Partnership, etcJ: ~e+YC _
1.2 I.RS. Tax ID No. or Social Security Number: 2.: ~' !o- OOO - ~5
2. Operation name (pit. mine or site Hamel: Pawn,-t7. t..~r~Y oiV - 4tT
3. Permitted acreage Inew or evstieQ site): 9'i/ permitted acres
3.1 Change in acreage (+) ~ ~ acres
Total Acreage in Permit Area 9, {~ acres
4. Fees:
4.1 New Application: 1 094.00 application fee
Amendment Fee (C.R.S. 34-32.5-125(II)): ~ \8~~ -$41900r application fee
4.2 Conversion Fee (from 110d to 110 875.00 conversion fee (Rule 1.11.2(2))
5. Primary rnmmodrtie(sl to be mined: ~~~ GrRA~I~
5.1 Incidental commoditie(s) to be mined: I.~O/ l on 2. / ibs/Tonshr 3. _ / (bs/fons/vr
Q..Q SAP
4. / lbs/T~ 5. / lbslTons/Yr
5.2 Anticipated end use of primary commoditie(s) to be mined: ~-oAa MAtac~-u~Ls
Anticipated end use of incidental commoditie(s) to be mined: fie'. ~o N ~orT1 CLOL/ ~anl~ S QoAD MAIi~ ,