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STATE OF COLORADO <br />DIVISION Of MINERALS AND GEOLOG~ <br />Department of Natural Resources ~~rQ'a <br />3;~~ <br />1313 Sherman SL, Room 215 I " ~ C O L O RAD O <br />Denver, Colorado 80203 ~UC 2 ~ MINERAL S <br />Phone: (303) 86[x3567 CONSTRUCTION MAT'ERIAI.S ?~~5 fx <br />FAX: (303) 832-8706 REGULAR I12 OPERATION sici ; G E O L O G Y <br />Di <br />( ) a1Ji f~'i'':I, jlg REGIANATION•NI NING <br />RECLAMATION PERMIT APPLICATIONFORME/ eoio® fAfETYKCIENCE <br />Bill Owens <br />Govenror <br />CHECK ONE: There h a File Number Already Assigaed to this Operation <br />Russell George <br />Permit # , vi -_ _ _, (Please reference the file ntmiber currently Bssigned to tlris operation) E"e<'"IVe Director <br />Ronald W. Cattany <br />_ New Application (Rule 1.4.5) _ Amendment Application (Rule 1.10) Divlslon Director <br />Conversion Application,(Rule 1.11) Natural Resource Trustee <br />Permit # M -L~~'~-~ (provide for Amendments and Converolons of existing permits) <br />The application for a Construction Materials Regulaz 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exlnbit; and (3) the application fee. When you submityour <br />application, be slue to include one (I) complete sieved and notarized ORIGINAL and one (1 } copy ofthe completed applicationform,ttyo (2) <br />copies of Exhibits A-S, Addendum 1, appropriate sections of6.5 (Geotechnical Stability Exhibit, and a check for the application fee described <br />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 8112" X 14" size. To <br />expedite processing, Please provide the iaformalion in the format apd order described in this form <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL iatormation requested below. <br />r' <br />1. ApolicanUoperator or comnanvname (name to be need on cermitl: RI I fY\ GL(l~r-l'((~P,r ~(~l IlC1'~~2 C S 1~1(" .. <br />I.1 Type of organization (corporation, partnership, etc.); <br />2. Operation name (pit. mme or site namel: <br />3. Peroiltted acreage (new or eaGtine aria): <br />3.1 Change is acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New t2iiarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: d Yid rG.~12I <br />~~'~~ permitted acres <br />__~L_L~K,~!M__l~-' acres <br />acres <br />$2.344.00 application fee <br />$2.906.(LO quarry application <br />$1.938.00 amendment fee <br />2 344. eversion fee <br />5.1 Incidental commoditie(s) to be mined: 1. lbs/Tonsf~rr 2. / ibs/I'oas/vr <br />3. / lbs/fons/y; 4. / lbs/Tons~/ r 5. ,n/ lbs/tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: C1(lYIS~,'[l 1 f ~l ~ ~ 1~C7Ad <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />Office of OHice of Colorado <br />Mined Land Reclamation ARive and InacY~ve Mines Geological Survey <br />