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<br />DIVISION OF MINERALS AND GEOLOGY <br />Department ui N,uural Resources <br />131 1 Sherman $L, Rnum 215 <br />Denver, Colorado N0203 <br />Phone: (3051 tl66J5hi <br />FAX'. l 1031 NS2~8106 <br />i <br />C-T"A'-~-*" Q~ COLORADO <br />Illlllllli111111111• ~ <br />NOV 0 5 2001 <br />Division of Minerals and Geology <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />~~ <br />D I VISION O F <br />MINERALS <br />6c <br />GEOLOGY <br />RECLA MATIONI <br />MINING•SA FETY <br />RECLAMATION PERMIT APPLICATION FORM Bill Owens <br />Gmernor <br />Greg E. Walther <br />E.ecurive Drmclor <br />CHECK ONE: New A lication Rule 1.4.5 Amendment A lication Rule 1.10~(~t'chael 6. Long <br />PP ( ) PP ( Division Dneaor <br />R Conversion Application (Rule 1.11) <br />Permit # M -~_- 019 -_ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major pare: (I) the application form; <br />(2) Exhibits A-S, Addendtan 1, any sections ofExhiba 6.5 (Geatechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) comolete simed and notarized IVORY ORIGWAL and four (4) copies of the completed Ivor <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the applicarion fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to <br />8 1!2" X I 1 " or 8 1 /2" X l4" size. 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, in the space provided, ALL information requested below. ,,pp ~1„<S la <br />I. AuoBcanUooerator or comoatrv name (Dame to be used o0 trermitl: BACA CODN7'Y <br />1.1 Type oforgani7ation (corporation, partnership, etc.): GOVERNMENTAL ENTITY <br />1.2 I.R.S. Tax i.D. No. or Social Security Number: / <br />2. Qperatiotr name (nit, mine or site name): M[JNDELL PIT #32 <br />3. Permitted acreaee (new or existine site): <br />3.l Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quany Application <br />4.3 Milting Application (Non-DMO) <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: ROAD BED MATERIAL <br />5.1 incidental commoditie(s) to 6e mined: L Ibs(fonslvr <br />3. / Ibs/Ions/vr 4. / IbsRons/vr <br />9.12 permitted acres <br />30.88 acres <br />40-00 acres <br />51.875.00 application fee <br />52.325.00 quarty application <br />E3.100.00 milling application <br />81.850.00 amendment fee <br />51.875.00 conversion fee <br />2. ! Ibsfl'onslvr <br />5. / Ibs/fons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: HHFN ROAD MATERIAL ~ IS DEPLETED. <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: N/A <br />