Laserfiche WebLink
~~~~~~rvr~ <br />~iOV 17 %CC4 ~ <br />CONSTRUCTION MATERIALS tiisisian of 8;r,~ ~~ ~ ~°~~t'.t <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE There is a File Number Already Assigned [o this Operation <br />Permt # ~-_ _ _ (Please reference the file number currently assigned to flits operation) <br />_ New Application (Rule 1 4 5) ,Amendment Application (Rule ].10) <br />~_ Conversion Applic on (Rule 111) <br />Permit # M - 1978- 314 -_ (provide for Amendments and Conversions of existing permits) <br />The apphcatton for a Consvucnon Ma[enals Regular 112 Opemtion Reclamation Permit contains three mayor parts (1) the application <br />form, (2) Exhibits A-S, Addendum 1, any sectons of Exhtbit 6.5 (Geotechntcal Stability Exhtbit, and (3) the apphcatton fee. When you <br />submit your applicattoq be sure to include one (1) complete siened and notarized ORIGINAL and one (I) copy of the completed <br />application form, two (2) copies of Ezhtbtts A-S, Addendum 1, appropnare sections of 6.5 (Geotechnical Stability Exhtbit, ands check for <br />[he apphcahon fee descnbed under Sec[ton (4) below Exhibits should ~O'[ be bound or in a 3-nng binder, maps should be folded to <br />8 112" X 1 I" m 8 1 /2" X 14" sae. To expedite processing, please provide the mformahon m the format and order descnbed m this form <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />1 Aanlicantlaoerator or comoanv name /name to be used on permit): Klng Mountain Gfayel LLC r' <br />I I Type of organization (corporation, partnership, etc.): Limited Liability COfpOfatlOll <br />1 2 I R.S Tax I D No or Social Secunty Number ZO-1124020 <br />2. Operation namelnit. mine or site Hamel: Kipp Mountain Sand & Gfayel Mlne / <br />3 Permitted acreaee (new or exis[in¢ site) <br />3 I Change m acreage (+) <br />3 2 Total acreage m Permn azea <br />1 O permitted acres <br />331 acres <br />341 acres <br />4 Fees <br />4 I New Application 52.344 00 application fee <br />4 2 New Quarry Application x.906.00 quarry apphcahon <br />4 4 Amendment Fee $1.938.00 amendment fee <br />4 5 Conversion [o 112 operation (set by statute) X344 00 conversion fee <br />5 Primary commoditiels) to be mined: Sand gravel <br />5 1 inctdental commoditie(s) to be mined: 1 N/A - Ibs/Tons/yr 2 / Ibs/Ions/vr <br /> 3 / Ibs/Tons/vr 4 / Ibs/TonslKr 5. / Ibs/Tons/vr <br />5.2 Antiapated end use ofpnmary commoditie(s) to be mined: COllStfuCtiOtl Aggfeg ateS <br />5 3 Anticipated end use of inctdental commoditie(s) to be mined. N/A <br />