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<br />STATE OF <br />DIVISION OF MINERALS AND GCOIOGY <br />Depamnent of Natural ResotRCes <br />1313 $hemnn SL, Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 9663567 <br />FA%: (303)932-0106 <br />CONSTRUCTION MATERIALS~~ <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />~%~' <br />~~ ,*- ntvNEtRALS <br />~'`' ~ S~ <br />OLOGY <br />MAR ~ ~ ~~ EE f3 ffTYI3CIENCENG <br />Diwarono(Mmere)sand n,@_lo»e~a <br />CHECK ONF.: X There 6 a Fik Number Akeady Assiped to thG Operation ~^~99r <br />/ Ruuell Geo'ge <br />Permit # M - 19'. 91 ~-0 74 (Please reference the file number cturently assigned to this operation) E•Pb11e oired« <br />New A lication Rule 1.4.5 X Amendment A lication Rule 1.10 Rauld w. Granny <br />PP ( ) PP ( ) Division DinaYOr <br />_ Converoion Application (Rule 1.11) Nuurai aero«ce rraaee <br />Permit # M - 19' -~~- 074 (provide for Ameodmeota and Converaiooa ofezisting pemuts) <br />The application for a Construction Matetials Regulaz 112 Operation Reclamation Permit contains three major parts: (I) the application forth; <br />(2) Exhibits A-S, Adderdtau I ,any sections of Exhibit 6.5 (Geotechnical StabiliTy P.xhibit; and (3) the application fee. When you sulmu[your <br />application, be sure to include one (i) comDle[e limed and notarized ORIGINAL acid one (1) copy of the complrtcd application fomr, two (2) <br />copies ofExhibits A-S, Addendtatl 1, appropriate sections of 6.5 (Geotechrrical Stability Exhibit, and a check for the application fee descrilxxi <br />under Section (4) below. Exhibits should NOT be bound or N a 3-ring binder; [naps should be folded [0 8 l2" X 11" or g l2" X 14"size. To <br />expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION I1dFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />1. ADOlicanUooerotor or mmnanv name (name to be used oa txrmi0: Kiowa County `- <br />l.l Type oforge[tization (corporation, partnership, elcJ: Government <br />2. Ooerafpn Dame (nit, mine or site Dame): Barnett Pit <br />3. Permhted acreatre (new or etdatina aite): <br />3. t Change in ataeage (+) <br />3.2 1bta1 acreage in Permit area <br />4. Feea: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Prbnan• commodkkfa) to be mined: Gravel <br />5.1 Incidental corwnoditie(s) to be mined: 1. - Ibs/fons/yr <br />3. / Ibs/fons!~r 4. / IbsR'ons/vr <br />24.6 permitted acres <br />10.4 acres <br />35. acres <br />$2.344.00 application fee <br />52.906,00 quarry application <br />$1.938.00 amendment fee <br />$2344.00 conversion Fee <br />2. 1 lbsll'ons/vr <br />5. / tbs/fonshr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Gravel <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: Road Base <br />ORice of <br />Mined land Reclamation <br />l7fflce of <br />AAive and Inactive Mines <br />Colorado <br />Geologinl Survey <br />