REV89482

• Permit No: M1978210
• IBM Index Class Name: Revision
• Doc Date: 7/8/1998
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM3
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
Depadmenl of Natural Resources
1313 Sherman St., Room 215
Dem•er, Colorado 80203
IlC VV C Y C
RE/'E1VE~
Phone: [phone]
FAX:[phone]
JUL O R ,1998 DEPARTMENT OF
NATURAL
Division of Minerals & Geo~FSOURCES
CONSTRIICTION MATERIALS
REGQL7IR (112 ) OPERATION Roy Romer
~
~
RECLAMATION PERMIT APPLIGTION FORMn , ~ //~ Governor
Lochhead
Y(Q ~ lames 5
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~Y- /1/i~ Executive DireclOr
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C/')! ~
pnichael B. Long
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Division Director
CHECK ONE: New Application (Rule 1.4.5) ~ Amendment Application (Rule 1.10)
Conversion Application (Rule 1.11)
Permit # M - 78 - 210 - No.l (provide for Amendments and Conversions of
existing permits)
The application for a Construction Materials Regular 112 Operation Reclamation Permit contains
three major parts: (1) the application form; (2) Exhibits A-S, Addendum 1, any sections of
Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your
application, be sure to include one (1) complete signed and notarized IVORY ORIGINAL and four (4)
copies of the completed Ivory application form, five (5) copies of Exhibits A-S, Addendum 1,
appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application fee
described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps
should be folded to 8 1/2" X 11" or 6 1/2" X 14" size. To expedite processing, please provide
the information in the format and order described in this form.
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GENERAL OPERATION INFORMATION
Type or print clearly, is the eyace yrovided, ALL information requested below.
1. Apvlicaat/operator or company name (acme to be used on permit):
Weld County. Colorado
1.1 Type of organization (corporation, partnership, etc.): Government
1.2 I.R.S. Tax I.D. No, or Social Security Number:
2. O peration acme (Dit, mine or site name): Geiserr P it
3. Permitted acreage (new or existin4 site): 142.5 permitted acres
3 .1 Change in acreage l+ or -) -28.9 acres
3 .2 Total acreage in Permit area 113.6 acres
4. Fees:
4 .1 New Application 51,875.00 application fee
4 .2 New quarry Application $2,325.D0 quarry application
4 .3 Milling Application (Non-DMO) 53,100.00 milling application
4 .4 Amendment Fee 51,550-00 amendment fee
4 .5 Conversion to 112 operation (set by statute) $1,875.00 conversion fee
5. Primar y commoditie(s) to be mined: (: avel
5 .1 Incidental commoditie(s) to be mined: 1. N/A lbs/Tons/yr
2. / lbs/Tons/vr 3. / lbs/Tons/yr
4. / lbs/Tons/vr 5. / lbs/Tons/vr
5. 2 Anticipated end use of primary commoditie(s) to be mined: Construction material
5. 3 Anticipated end use of incidental commoditie(s) to be mined: N/A