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-Z <br />STATE OF <br />DIVISION OP MINERALS AND GEOLOGY <br />Department of Natural Resources <br />RECEIVED <br />1313 Sherman St., Room 215 f, <br />Denver, Colorado 80203 CONSTRUCTION MATERIALS FEB 2 't 2UU(t/ <br />~~~~ REGULAR (112) OPERATION <br />RECLAMATION PERMTT APPLICATION FORl~tision ai Minerals and heal <br />f®I~ SCANNING <br />CI~CK ONE: X There is a File Number Already Assigned to this Operation <br />LORADO <br />I S F O N O F <br />NERALS <br />~IEOLOGY+ <br />XFCLANATION•NINING <br />SAFETY•SCIFNCE <br />aitl Owens <br />Governor <br />Pemut # M 1977-15~~ (please reference the file number current) asst ed to this o erasion) erect E. watcher <br />y gn P Ezttulive Director <br />_ New Application (Rule 1.4.5) _~_ Amendment Application (Rule 1.10} Ronald w. Canany <br />Conversion A Ilcation rile 1.11 Division Director <br />-.- PP <R ) NaNal Resource Trustee <br />Permit # M -` _ (provide for Amendmeeta and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application forrn; <br />(2) Exhibits A-S, Addendum 1, a~ sections ofExhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sane to include one (1) complete limed and notarized IVORY ORIGINAL and one (1) copy ofthe completed I~ application <br />form, two {2) copies ofExhibits A-S, Addendlnn 1, appropriate sections of 6.5 {Geotechnical Stability Exhibit, and a check for the application <br />fee described under Section (4) below. Exhibits should NOT be bound a<in a 3-ring binder, maps should be folded to 81 /L" X 11" or 81/2" X <br />14" size. To expedite processing, please provide [he information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the apace provided, ALL information requested below. <br />City an ounty o Denver, Acting by an, <br />1. AnnlicanUonerator or rnmoanv name (name to be used on uermitl:through its Board of Water Conunissioners <br />1.1 Type of orgmization(corporation,pa,itnership,etc.}: (Denver Water) lmtnicipality <br />1.2 I.RS. Tax I.D. No. or Social Security Number: Fade ral <br />n ~&3/ilbd <br />2. Oceration name (oil. mine or site name): 1' ~.(~!(llYllll~~I~l I"'i {- O~Yf . <br />3. Permitted acreage {o~ or eaistioe site): <br />3. I Change in acreage (+} <br />3.2 Total acreage in Permit area <br />4. Fces: <br />4.1 New Application <br />4.2 New Quany Application <br />* 4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />111.20 permitted acres <br />48.65 acres <br />159.85 acres <br />x~Rti~bAA~ac <br />~x ~EtIFt~iib~ildiit <br />$1.938.00 amendment fee <br />t®4X3~AII>sxrElill3i#iliii#fe~ <br />5. Primary commoditie(s) to be mined: sand gravel <br />5. I Incidental commoditie(s) to be mined: 1. - ]bsfl'onshr <br />3. ! lbs/Tons/vr 4. / Ibs/I'onshr <br />5.2 Anticipated end use of primary commoditie(s) to be trained: N/A <br />5.3 Anticipated end rue of incidental commoditie(s) to be mined: N/A <br />2. ! Ibs/1'ons/vr <br />5. / Ibs/fons/vr <br />Office of Office of Colorado <br />Mined land Reclamation ~ Active and inactive Mines Geological Surve;- <br />