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TATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ~~Vp~ <br />Department of Natural Resources A ~V <br />1313 Sherman SL, Room 215 AP/,? DIVISION O F <br />Denver, Colorado 80203 T) 1 Z~42 MIN &RA L $ <br />Phone: (303) 866-3567 O <br />FAX: (303) 832-8106 <br />~ry/sro~of~9o Fjo G E O L O G Y <br />REGULAR TIONOPERA ON M/ne~a/ ~O epe M EN f N GM ATF EST Y <br />RECLAMATION PERMIT APPLICATION FORM ~y Bill Owens <br />Governor <br />Greg E. Walther <br />Executive Director <br />CHECK ONE: _ New Application (Rule 1.4.5) ~c Amendment Application (Rule 1.1 iehael s. Long <br />Division Director <br />Conversion Applicafion (Rule 1.11) <br />Permit # M -_ ~~-(provide for Amendments and Conversions of exisfing permits) <br />The application for a Construction Ivlatedals Regulaz 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical StabilityExhibit; and (3} the application fee. When you submit your <br />application, be sure to include one (1) complete siened and notarized IVORY ORIGINAL and four (4) copies of the completed Ivory <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical StabiliryExhibit, and a check for the . <br />applicafion fee described under Secfion (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 lYL" X 11" <br />or 8 lYL" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION TNPORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />I. Applicant/onerator or company name (name to be used on uermit): Q'~CASTLE ~~ fOfaOOP ~ AIC. DAA FOUR <br />1.1 Type of organization (corporation, partnership, etc.): e17RIbP~t ~OA1 CO~N~S <br />1.2 I.R.S. Tax I.D. No. or Social SecurityNumber; -t-RH -B'i49S3b iK~IR~. <br />2. Operation name (oit, mine or site name): t ~~M.AS ~t'`T <br />Permitted acreage (new or existing site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit azea <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: ~Oi~V$L <br />5.1 Incidental commoditie(s) to be mined: 1. - lbs/I'ons/vr <br />.~4. g~ permitted acres <br />Jam. t~f acres <br />. g acres <br />$2.344.00 application fee <br />$2.906.00 quarry application <br />(~1.938.0(t amendment fee <br />$2.344.00 conversion fee <br />2. / lbs/I'ons/vr <br />3. / lbslpons/vr 4. / lbs/I'ons/vr 5. / lbs/Tons/vr /-- -- <br />5.2 Anticipated end use of primary commoditie(s) to be mined: ~fl~T'7F~Or['- l.' ,uc,e~I;c~r.PvA~ ~24v~L <br />5.3 Anficipated end use of Incidental commodite(s} to be mined: <br />