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ONSTRUCTION MATERIALS <br />REGULAR (] 12) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Permit # M -_ _ _ (Please reterence the.file number currently assigned to this operation) <br />_ New Application (Rule 1.4.5) R Amendment Application (Rule 1.10) <br />J Conversion Application (Rule i.l l) <br />Permit # M -_~9,Q q 16 -_ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular lit 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 yov <br />submit your application, be sure to include one (1) comolete signed and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check 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 1" or 8 I/2" 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 />Apolicantlooerator or company name (name to be used on permit): Lafarge West, Inc. <br />L1 Type of organization (corporation, partnership, etc.): Corporation <br />1.2 LR_S. Tax LD. No. or Social Security Number: <br />2. Ooerationname(oit.mineorsitenamel: Riverbeitd Operation <br />3. Permitted acreage (new or ezistin¢ site): <br />3.1 Change in acreage (+) <br />32 Total acreage in Permit area <br />4. Feu: <br />4.l New Application <br />4.2 New Quany Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />437 permitted acres <br />931 acres <br />__l 3fi8 acres <br />52.344.00 application fee <br />52.906.00 quarry application <br />51.938.00 amendment fee <br />$2.344.00 conversion fee <br />5. Primary commoditiHsl to be mined: Sand Gravel Fill <br />5.1 incidents! commoditie(s) to be mined: 1. NA - Ibs(rons/yr 2. 1 Ibsll'ons(yr <br />3. ! !bsll'ons/vr 4. ! Ibs(I'onslvr 5. ! Ibs/I'ons/vr <br />5.2 Anticipated end use of primarycommodtie(s)tobemined: Construction Materials <br />53 Anticipated end use of incidental commoditie(s) to be mined: <br />