REV98980

• Permit No: M1995034
• IBM Index Class Name: Revision
• Doc Date: 9/5/2000
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT 110 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM1
• Media Type: D
• Archive: No

DIVISION OF h11NERALS AND GEOLOGY
Uepanment of Natural Fesources
I i I }Sherman S[_ Foom '_ 15
Genver, lolorado 80:G}
Phone [phone];
FAx: I}p} 183?-9106
III IIIIIIIIIIIII III T
SEP 0 5 2000

OF COLORADO
Division pi Minerals and Geelogy
CONSTRUCTION ~fATER1ALS
LIMITED liV1PACT (110j OPERATION
~~
DIVI)ION O
MINERAL'
GEOLOG`
RECLAMArIOF
MINING•SAFE71
RECLAD[ATION PERhIIT APPLICATION FORpI 9.n v.°e^>
Governor
Greg E bVOl~her
Exccnrve Dlmaor
Alichacl B. Long
CHECK ONE: There is a File Number Already Assigned to this Operation Dins~on O~reaor
Permit # M -~- 03 -_ (Please reference the file number currently assigned to this operation)
New Application (Rule 1.4.5) ~Arnendment Application (Rule I.10)
Conversion Application (Rule 1.1 I)
Permit # M -~~- d3 ¢_ (provide Cor Amendments and Conversions of existing permits)
The application for a Construction Materials Limited Impact (I ]0) Operation Reclamation Permit contains three major parts: (1) the
application Form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by
the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(I)(b); and (3) the application fee. When you submit your application, be sure
to include one (1) complete signed and notarized IVORY ORIGLNAL and one (1) copy of the completed No application form, hvo (2)
copies of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check
for the application fez described under (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 I/2"
X 11" or 8 112" X 14" size. To expedite processing, please provide the information in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, ALL information described below..
I. Applicant/operator or company name (name to be used on permit):
p
1.1 Type of organization (corporation, pannership, etc.): ~AN /EL //7• /1 usSFLL
~ .SoCr
plot/ G~.e
I ~ I.R.S. Tax ID No. or Social Security Number: 2.: ~
2. Operation name (pit, mine or site name): 7JA L fI NS P~ ~
3. Permitted acreage (new or existing site): r~ 98 / petmiucd acres
3.1 Change in acrea¢e (+) ~' 9(oz acres
Toial Acreage in Permit Area 9.943 acres
4. Fees:
4.1 New Application: $1,094.00 application fee
Amendment Fee (C.R.S. 34-32.5-125([q): - - $719.00 application (ee
4.2 Conversion Fez (from I lOd to 110 $875.00 conversion fee (Rule 1.11.2(2))
5. Primary commoditie(s) to be mined: ~/ r~ Sig AvD 6r.4 uFL
5.1 Incidental commoditie(s) to be mined: I. / Ibs/i'ons/vr 2. / Ibsli'ons/vr 3 . / Ibs/i'ons/vr
4. / Ibs/i'ons/vr 5. / Ibs/pons/yr
5.2 Anticipated end use of primary commoditie(s) to be mined: ~/ L L /Y/A7E.P/A L
Anticipated cod use of incidental commoditie(s) to be mined: NJ nl f