Laserfiche WebLink
TATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />7373 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS <br />FAX: f303) 832-8706 <br />LIMITED IMPACT (110) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />COLORADO <br />DIVISION O F <br />MINERALS <br />GEOLOGY <br />0.ECLAMATION•M WING <br />SAf ETY•SCIENCE <br />Bill Owens <br />Governor <br />CHECK ONE: _~ There is a File Number Already Assigned to this Operation <br />Permit # ,~-19 78 0 8 0_ (Please reference the fife number cturendy assigned io this operation) <br />New Application (Rule 1.4.5) X Amendment Application (Rule ].10) <br />Conversion Application (Rule 1.11) <br />Permit # M ~ 9 ~ 8. 0 8 0 -_ (provide for Amendments and Conversions of existing permits) <br />Greg E. Walther <br />Executive Director <br />Ronald W. Catlany <br />Division Oirector <br />Natural Resource Trustee <br />The application for a Construction Materials Limited Impact (I 10) Operation Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geo[echnicai Stability Exhibit. as required by the Ogce, and <br />outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(I)(b); and (3) the application fee. When you submit your application, be slue to include one <br />(I) complete sieved and notarized IVORY ORIGINAL and one (1) wpy of the completed Iwn application form, two (2) copies of Exhibits <br />A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for [he application fee <br />described under (4}below. Exhibits shotild ~ be bound or in a 3-ring binder; maps should be folded to S l/2" X 1 1"or S 1/2" X 14"size. <br />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, io the space provided, ALL information described below. <br />AopHcantJocerator or coronanv name (name to be used oe cerrokl: L i n c o 1 n Count y <br />1.1 Type of organization (corporation, partnership, etc.): Government <br />1.2 1.2 I.R.S. Tax ID No. or Social Security Number: <br />2. Operation Dame (nit. mine or site Hamel: E 1 n e <br />3. Permitted acreage (new or e7tistin¢ sitel: <br />3.1 Change in acreage (+) <br />3.2 Total Acreage in Permit Area <br />4. Fees: <br />4.] New Application: <br />Amendment Fee (C.R.S. 34-32.5-125(II)): <br />4.2 Conversion Fee (from 1 IOd to 110 $875.00 conversion fee (Rule 1. ] ].2(2)) <br />~. Primarvrnmmoditie(sltobemined: Sand GYavel <br />7 _ S permitted acres <br />8 . 4 acres <br />9 ' 9 acres <br />$1,094.00 application fee <br />$719.00 application fee <br />5.1 Incidental commoditie(s) to be mined: I. NA / Ibs/Tons/t~ 2. / lbs/Tons/vr 3. ! ibs/1'ons/vr <br />4. / IbslConshT ~. / Ibs/Tonshr <br />5.2 Anticipated end use of primar}~commoditie(s)tobemined: County Road Maintenance <br />Anticipated end use of incidental commoditie(s) to be mined: <br />NA <br />Office of Office of Colorado <br />Mined Land Reclamation Active and Inactive Mines Geological Survey <br />