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STATE OF COLO~ZADO <br />DM90N OF MINERALS AND GEOLOGY RECEIV <br />txP.maaft a Natural ltcaurca ~~ <br />t 3t 3 Shemfan St, Rosa xt s C O L D RA D O <br />Oala'Cr, ~Alofido 8nx03 <br />OCT 1 P Y ( V I S I O N O F <br />I N <br />RA L S <br />Phone: 1303) 8663567 CONSTRUCTION MATERIALS S <br />FA7t: 13837 ux-0106 REGULAR (1l2) OPERATION G E O L O G Y <br /> RECLAMATION PERMIT APPLICATION FOl~aton of Minerals and fir'°"'"'"'"` <br />••SOF"Cf <br />Bill Owtl15 <br />G(IVt.f~lA <br />CHECK ONE: There m x File Number Already Aogned to thb Operation <br />au9ru eeo'ae <br />Permit # M -_ _ _ (Please refererre the file numbs ctarrntty assigned to this operation) Fzaoai~c tareun <br />New Application (Ruk 1.4.5) ~ Amerfdmeat Application (Rule 1.10) a ~ p,~ <br />Coavenioa Applicetifm (Rule 1.11) NaWaI t4soa~a Tnaae <br />Permit # M -_d~/Z~~(provide for Amendmmta avd Conveniom of existing permits) <br />The application fur a Corutntction Materials Rcgttlar 112 OpaationReclantation Peratit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addctdmo 1, arty auctions of Exhibit 6.5 (Geotxlmical Stability Exhibit; and (3) the applicatim lce. When you submityour <br />epplif:atian, be sure to incltde tote (I) fbrrfplae sigt~and notarved ORIGINAL s~ one (I) copy of the completed appiicationfonn, two (2) <br />copies of tlrdtibits A-S, Addendum 1, appropriate sections of 6.5 (CfeotechnicN Stability Exhibit, and a check feu the application fee desmbeft <br />under Section (4) below. Etilttbits should NOT be bound or in a 3-ring bitrdc maps should be folded to 8 I tZ' X l l" or 8 i f2' X 14" fine. To <br />cxPfxlite P~& Please provide the information in the format and orhi described N this lam <br />(;F:NERAL OPERATON INFORMATION <br />2. Otoa ntbn wme ldt_ rase or Nee Dame): <br />3. Permitted aercaee (new or eifatine site): ~8 f~pertnined aces <br /> 3 <br />S <br />3.I Change in afxeage (+) _ <br />o_ acres <br />• <br />3.2 Taal afueage N Permit area E acres <br />4. Fcea: <br />4.1 NewApphcation $2.344.00 apphrationfce <br />4.2 New Quarry Application $2.906.00 quarry application <br />4.4 Amendtrfent Fee $1.938.00_ anferdment fee <br />45 Conversion to 112 opetatifm (set by :nattae) $2.344.00 conversion fee <br />~. PFim arv oammodYiefa) to be m®ed: ~~ ~RNVG(i ~~ __ _ <br />5.1 Incidfmtel cfmtmoditie(s) to be mirfed: 1. Ibs/fon <br />~ <br />_ s/vr 2. ! lbs/1'onsM <br /> 3. / lbs/I'ons/vr 4. <br />/ <br />ihs/Con sJvr 5. / Ibs/fonshT <br />5.2 Anticipated end use of primary cenmtoditie(s) to be mined: r/ f{GIRI~E <br />5.3 Anticipai~ eud use of ira;idental commoditie(s) to be mined: _ _ <br />Ofice of Otfice of Colorado <br />ea'ofed lad ReclartfYian Meive rid hfxtive 6liffes Geot(fgKal $U[YeY <br />Type or point clearly" m tlk apam Provided, ILL information requested belfnr. <br />