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STATE OF COLORADO <br />Dry1510N OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1713 Sherman St., Room 215 <br />C O L O R A D O <br />Demwv, Colorado 80203 r <br />Phone- (303{ 6663567 CONSTRUCTION MATERIALS REC <br />LAMATION <br />FAX: (303) 832.8106 REGULAR (112) OPERATION M 1 N I NG <br />-&- <br /> RECLAMATION PERMIT APPLICATION FORM SAFETY <br /> Bill OWMS <br />Gove"wr <br />CHECK ONE: There fe a Pik Nu~er Already Assigned ro lhh OperatMo <br />R II Gepge <br />Q ^ usse <br />Pemrit # ~,-~- ~) V -Q~S (Place referetrce the file number cumcutly assigned to this q~erafl~h'" O'r°"or <br />ttorald W. Cattany <br />_ New Application (Ride 1.4.5) _ Ameodorent Application (Ruk 1.10) avl.ian wrertor <br />_ Conversion Application (Ruk I .I 1) wrural Rnarrce rnKtee <br />Permit # ~_-~' ,_- r) v -Q~ (provide for Amendment and Conversbrs of existing pernrite) <br />The application For a Construction Materials Regular 112 Operation Rcebmatieu Perogt cwntains three rmjor parts: (!)the application <br />form; (2) Exbibib A-S, Addendum 1, any sceti~a of Exiribit 6.5 (Geotcelarical 3bbility Exh~it; and (3) the application fee. Whew yar <br />submit your applicatioq be sure to inehde one (1) comokte sued end notarized ORIGINAL Bad ate (1) copy of dte coarpkted <br />applicatan fortq taro (2) copies of Exhibits Ate, Addendum 1, appropriate sections of 6.5 (Cxolee6nical Stability Exhibit, and a check far <br />the application fce described under Section (4) below. Exhibits should ~ be bawd or in a 3-ring birder; mope should be forted to <br />8 i/2" X 11" or 8 112" X 14"size. To expedite processing, please provide the infanmtion b the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, fo the space previded, @~ ln[ormation requested bebw. <br />I. AoMkaatlooentor or rntmanY name (name ro be need on oerndt-: ~ L g, r» t/ Cl n S ~~y G~ `Or~~ n G . <br />L 1 Type of orgsoiration (corporation, partnership, etc.): <br />2. Qper ation Warne (olt. mine or site oamel: ~ h C2il~ f S li'~-~ <br /> <br />3. Perrr dtted aereaae (new or a:btia, < site: ~ 0 ~1. permitted acres <br />3.1 Change in acreage (+) O acres <br />3.2 Total acreage in Permit area ~ ~ y r 7 acres <br />4. gyp: <br />4.1 New Application 52.344.00 application fee <br />4.2 New tZuany Application 52,906.00 quarry application <br />4.4 Amendmem F« S 1.938.00 amerdnrem fee <br />4.5 Conversion to 112 operation (Bet by statute) 52.344.00 conversion fee <br />5. Pdma rv eorrurroditk(s- ro be mined : ~ _ <br />5.1 Inciderdal cotrtatoditie(s) ro be rrtirted: 1. IbslCorm/vr <br />2. ! Ibs/fortslvr <br />3. / IbsR'orrslvr 4. / ibe/fons/~ 5. / IbaCfons/vr <br />5.2 Aaticgmted end use of primary conmroditie(s} to be mined; C d n ~~. f UC. ~I Ot'1 Mn ~e f l p ~ 5 <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />CNfice of Offke of <br />Mined land Reclamation _ Adive and Irtactlve Mines <br />