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i <br />~%~ <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY f/ <br />Departrtrem of Natural Resources <br />t3t3ShemunSL,Roomns p COLORADO <br />Denver, Wlorado a0z03 / IA ~~~r n ` vN t RA L S <br />Phone: t3n3) 8663567 CONSTRUCTION MATERIALS ~~ <br />FAX: (303) 832$106 REGULAR (112) OPERATION Y O L O G Y <br />RECLAMATION PERMIT APPLICATION FORM r1AR 1S9naECE"""noN•NININc <br />E fETY•EC IFNCE <br />Orwmono/Mmeralsand °: <br />CHECK ONF,: X There i+ a FRe Number ALeedy Assiped to th6 Operatbn <br />/ Russell Geolge <br />Permit # M - 19' . - 91' ~-07 4 (please reference the file number curreNly assigned to this operation) raEnrtive oinctor <br />New A lication Rule 1.45 X Amendmwt A lication ule 1.10 ~~ w. rxncy <br />PP ( ) PP ~ ) I)IVISIM Dhettor <br />_ Conversion Application (Rule 1.1 i) Naunl Rerourtss Trusee <br />Pemut # M - 19 -. -~~- 0 74 (provide for Ameudmeota and Couvenioua of esisling permits) <br />The application for a Construction Materials Regulaz 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Adcletdtmt 1, any sections of Exhibit 6.5 (Ceotechnical Stability Exhibit; and (3) the application fee. when you submit your <br />applicatiot, be sun to include one (1) cotnolete siazted and tatarized ORIGINAL and one (i) copy of the corttpleted application form, two (2) <br />copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application fee described <br />under Section (4) below. Exhibits should ~ be bound or in a 3-ring binds, maps should be folded l0 8 112" X 11"or 8 1 /2" X 14"sine. To <br />expedite processing, please provide the information in the format and order described m this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL intormation requested below. <br />1. A~plicaotlocerator or rnmosev name (name to be aced on cetmitl: Kiowa County ~ <br />1.1 Type of organization(coryxrra[ion,parurership,ete.): Government <br />2. Oceration Dame (oA. miee or site Dame): Barnett Pit <br />3. Permitted acretEae (nesv or evatine site): <br />3. i Change m acreage (+) <br />3.2 lbtal ae~reage N Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Appliwlion <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />i. Ptiroarv comrooditk(a) to be mined: Gravel <br />5.1 Incidental commoditie(s) to be mined: 1. - Ibs/I'ons/vr <br />3. / Ibs/fons/Kr 4. / Ibs/Tons/vr <br />24 . fi petnvtted acres <br />10.4 acres <br />35. acres <br />$2344.1X) application fee <br />$2.906,00 quany application <br />$1.938.!X) amendment fee <br />$2344.00 conversion fee <br />2. / 1bslTons/vr <br />5. / Ibs/Conshr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Gravel <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: Road Bas e <br />l~aioe of O%ia of Cobndo <br />Mined lard Reclamation Active and Inactive Mines Geological Survey <br />