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<br />DIVISION OF MINERALS AND GEOLOGY <br />Depanmem of Natural Resources <br />1313 Sherman St., Room 215 <br />Denier, Colorado 80203 <br />Phone: (3031 866-3567 <br />FAX: 13031 8328106 <br />s <br />STAGE C~~LC <br />pGr <br />APR ~ ~ t~y6 <br />n~1p09 <br />~IV(bldll pl IV111191bIS b ~ <br />CONSTRUCTION MATERIALS <br />REGULAR OPERATION (112) <br />RECLAMATION PERMIT APPLICATION FORM <br />~~ <br />DEPARTMEM OF <br />NATURAL <br />RESOURCES <br />Roy Romer <br />Governor <br />lames S. Lochhead <br />6ecwlve Duecmr <br />mi<hae~ B. Long <br />Division Dvecwr <br />CHECK ONE: New Application (Rule 1.4.5) X A~endaeat Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M _ 85 _ 218 __ (provide for Asendaeats and Conversions of <br />existing permits) <br />The application for a Regular 112 Operation Reclamation Permit contains three major parts: (1) <br />the application form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical <br />Stability Exhibit; and (3) the application fee. when you submit your application, be sure to <br />include one (1) complete signed and notarized IVORY ORIGINAL and four (4) copies of the completed <br />ivory application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 <br />(Geotechnical Stability Exhibit, and a check for the application fee described under Section (4) <br />below. Exhibits should not be bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" <br />or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and <br />order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly in the space provided the information requested below. <br />1. Applicant/operator or company name (name to be used on permit): <br /> Southwest Ready-T?ix, Inc. <br /> 1.1 Type of organization (corporation, partnership, etc.): corporation <br /> 1.2 I.R.S. Tax I.D. No. or Social Security Number: <br />2. Operation name (pit, mine or site name): Rich Pit M-85-218 <br />3. Permitted acreage (new or existing site) 87.0 permitted acres <br /> 3.1 Change in acreage (+ or -) 277.88 acres <br />- <br /> 36 <br />4~ <br /> 3.2 Total acreage in Permit area acres <br />4. Fees• <br /> 4.1 New Application 51,875.00 application fee <br /> 4.2 New Quarry Application 52,325.00 quarry application <br /> 4.3 Milling Application (Non-DHO) 53,100.00 milling application <br /> 4.4 Amendment Fee 51,550.00 amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) 51,500.00 conversion fee <br />5. Primary commoditielsl to be mined: Sand Gravel <br /> 5.1 Incidental commoditie(s) to be mined: 1. None - lbs/Tone/yr <br /> 2. / lbs/Tons/vr 3. / lbs/Tons/vr <br /> 4. / lbs/Tons/vr 5. / lbs/Tons/vr <br /> 5.2 Anticipated end use of primary commoditie(s) to be mined: concrete,asphalt,roads <br /> 5.3 Anticipated end use of incidental commoditie(s) to be mined: none <br />