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STATE OF COLORAD <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natuat Resources <br />1313 Sherman $t., Room 215 <br />~~EI VE <br />Denver, Cdorado 80203 p C O L O R A D O <br />~ O I V 15 1 0 N O F <br />Phone: {303j 8663567 <br />FA7tx {3o31 S3z-slob CONSTRUCTION MATERIALS ''JUL 0 6 ~ MI~ NGON <br />2~~~ <br /> REGULAR (112)OPERATION <br />-- sr- <br /> RECLAMATION PERMIT APPLICATIOHiUiORMf Reclamation, SAFETY <br /> Mining and Safety <br /> ' <br /> '~ <br />~ eiaOwens <br /> Govenwr <br />CHECK ONE: There is a Flle Number Already Assigned to this Operation R~rxli ~~ <br />Permit # M -_ ~ _ (Please reference the file number currently assigned to this opera"ie D"eCpf <br />Rrnuld W. Cattarry <br />_ New Application (Rule i.4.5) _ Amendment Application (Rule 1.10) Division Diredar <br />_ on~tve~trsion Application (Rule I.11) Natural Resource Trustee <br />Permit # ~~- d7I -_ (provide for Amendments and Conversions of existing permits) <br />The application for a Constroction Materials Regular 1 l2 Operation Reclamation Permit contains three major parts: (1) fhe application <br />form; (2) Exhibits A-S, Addendum 1, any sections of F,xhibit 6.5 (Geotechnical Stability Exhibit and (3) the application fee. When you <br />submit your application, be sure to include one (I) cal tple.~e 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 b.5 (Geotecbnical Stability Exhibit, and a check for <br />the applicarion fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to <br />8 I/2" X 11" or 8 1/2" X ld" size. To expedite processing, please provide the infornmtion in rite format and order described in this form <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space <br />information requested below. <br />1. Aoolicantlonerator or comoany natr~ (name to tie seed da/nermitl:LR,~'(/~( "(LU./T_T <br />1.1 Type of organisation (corporation, partnership, etc.): C ~~I~t~'~ C7 D!/~,C°A/!21> <br />2. Operation name (ott. mine or site oa~1: nA~F'/l1Gbi1/ ,~.~7 <br />3. Permitted acreage (new or eaiatlna site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Pemrit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to l 12 operation (set by statute) <br />5. Primary comrrtoditie/s) to be mined:~Gj~t <br />5.1 Incidental comtrrodttie(s) to be mined: 1. / S6 bbb ibsiTons/yr <br />3. / Ibs/Tons/vr 4. <br />5.2 Anticipated end use of primary conunoditie(s) to be mined: _ <br />5.3 Anticipated end use of incidental cotrunoditie(s)1o bemined: <br />Office of <br />Mined Land Reclamation <br />0?3. lyU permitted acres <br />56 • yd acres <br />$D.OO ~~ <br />$2.344 00 application fee <br />$2.906.00 quarry application <br />$1.938.40 amendment fee / <br />$2.344.00 conversion fee <br />2. ( ]bs/Tons/yr <br />5. ,' lbs/fons/v <br />Office d <br />Alive and Inactive Mines <br />