REV89500

• Permit No: M1986140
• IBM Index Class Name: Revision
• Doc Date: 2/11/2002
• Doc Name: FAX COVER
• From: CHARLIE SPIELMAN
• To: DMG
• Type & Sequence: AM1
• Media Type: D
• Archive: No

2/11/2002 18:94 FA% 719 852 5958
woRDS PLUS '~Ff;F.I~/Fn RY FAX r~o9
SEP 11 ~G1~
STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
Oepartmen[ of NaNral Resources
1313 Sherman St., Room 715
DCnver, Colorado 80203
Phone: [phone]
FAX: [phone]
DI VISION OF
MINEitALS
CONSTRUCTION MATF.RiAT_S
LIM1'TED fMPACT (110) OPERATION
am °.K~+
RECLAMATION PFIINIIT APPLICATION FORM Go"error
Greg E. Walther
Fxecrrrive Dircclor
Michazl B. Long
C1IECx ONE: New Application (Rule 1.4) Conversion Application (Rule ~1"~~" °"`cam
~_ Ammdmmt Application (CRS. 34-32.5-11D)
Pert # M • B~-1!}~„-_ (provide for Ameadment+ and Conversions of exis6ag pe>mits)
The applica~On for a Coostrucdon Materials Limited bnpau (1 IO) Operadoo Re eon Permit contains rlnrs major pans: (1) [he applitatioo form;
(2) Fxb7bits A-J, Exhibit 1, Addendum 1, any sections of Exbrbi[ 6.S and Geotechmcal S tabilityExhibi>; as required by ills Office, and outlined in Rules
6.1, 62, 63, 65, and 1.6.2(1)(b): and (3) die application fee. When you submit your application, he sure to include one (1) c~lete si erg ed sad
no[arin'd IVOBY OHIGJNAL and one (1) copy of the completed jgyapplicatioa form, two (2) copies of Exhibits A-J,1'.xbiba L• A nP„ ..m 1, and
appropriate stclions Df 6S (Geatechrlical Snbi7iry P.xhtbit), u required, and a check for the application fee dcatsibcd undo (4) below. Exhibits should
NOT be hound ra is a 3-ring binder; maps should be foldtd to 8 1/Z" X I 1 " or 81R"X 14" size. 1b ca~odite processing. please provide the information
in die format and order deatzibed in ibis form
Type or print dearly, !n the space provided, ALL information desuibed below.
~I~ILI 0.GAL ~-AT Sgtti,j~~~ et! Ly,T~'t:,.
1.1 Type oforgpni~~~+*(cmpas~adon.parmesship,etcJ: ~oR~o~-rtert
1.2 LRS.'Iax ID No_ m Sodal Security Nttmba: _~~ ~R~O ~ 34
ODeratioa ram! (OIL mine or site same); I _ HT ~ IT
3. Permitted aexraee (new or erivtine site);
3.1 ~ Chatlge in enrage (+)
Total Aawge in Permit Area

~=
4,1 NewApplicatiom
Ameadtneat Fee (CRS. 34.32.5-125(Il)):
~2 Coavesiaa Fen (from 110d to 110 8E 75.00 conversion fee (Rule 1.11.2(2))
Ptimarv rnlnmodieie(s) to be mined: SAND ~ G RA[7 _ _
GEOLOGY
RECLAMATION
MINING•SAFE7Y
~_permitted aces
2.'7.5' acres
~~ acres
51.094.00 application fee
IBB.DO $~ application tee
5.1 Inridenral comraodide(s) to be mined: 1. - / ]bs(I~s/yr 2. 1 lhs/I'oaclw 3. / lbsll'onslvr
4. / lba/J'onshr 5. / lbs/Coas/vr
t
52 Anticipated end use ofprimazycommadide(a)tobetnined: B,(ri t v_ nil5~r rr Yieu FQewD ~n_~scTR. ~- Ar~17;
5.3 Aatidpaced end use of incidental commoditie(s) to be mined;