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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY / <br />Department of Natural Resources ~ --~ <br />1313 Sherman St., Room 215 \ ~GC E~VED C O L O AA D O '~. <br />Denver, Colorado 80203 ~ A i® u t v t s r o N a r <br />Phone: 13031866-3567 (~' \ CON57'RL'CTiON MA"1'ERIALS Nl'V 2, 1nQ A.E ~ ILA NGON <br />FAx: 13031 832$106 ~'t REGULAR (I]2)OPERATION <br />J RF.CLAI1iATION PERMIT APPLICATION FO Sion Df Reclamat Ott, SA & Y <br />wing and Safe <br />aai oven; <br />Covenwr <br />CHECK ONE: There is a Fde Number Already Assigned to this Operation xn:sera c~rrg <br />Permit q ~i -_-_•_ (Please reference the file nttmber cuTmntiy assigned to this opeta(itiH)""" D;r~,n. <br />Ronald W. Uhry <br />_ New Application (Rote 1.4.5) ~,~AmendmeM Application (Rule t. ] 0) oir+~;n„ otr~+o. <br />`Conversion Appiicatio ' (Rule 1. t 1) NaN21 Resource Truaee! <br />Permit # M -~~,~~(provide for Amendmeats artd Conversions of existing pemrits) <br />The application for a ConshuMion trlatetiais Regular 112 Operation Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A$, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit and (3) the application fee. When you <br />submit your application, be sure to itlcludc one (l) Mete signed and notarized ORIGINAL aml one (1) copy of rho completed <br />application form, two (2) copies of Exhibits A-S, Adttetxhml I, appropriate sections of6,5 (Geotechnical Stability Exhibit, ands check fm <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder, maps strouid be folded to <br />8 I /2" X ! 1" or 8 1/2" X i4" size. To expedite processing, please provide the informafion in the format a»d order described in this form <br />GENERAL OPERATION IhIF'ORMATION <br /> <br />2. Qyieration name foil- mine or site nat}~.: <br />3. Perm itted acrease Inew or existine si~j: <br />3. t Chaage in acreage (+) <br />3.2 Total acreage in Pemtit area <br />4. Pces: <br />4.1 New Application <br />4.2 ~ tew Quarry Application <br />4.4 AtTtentiment Fee <br />4.5 Com ersion to 112 operation (set by statute) <br />5. Prittwrv rnmmoditids3 to be trained: ~~~ <br />5.1 Incidental comtnoditie(sj to be mined: L <br />3. ! _ IbsPfon.`~vr~l r 4. <br />5.2 Anticipated end use of primary commodirie(sj to be mined:( <br />5.3 Anticipated end ltse of incidental commoditie(s) to be mined: <br />Office of <br />Mined Land Reclamation <br /> <br />~Lb~ permitted acres <br />~ acres <br />" acres <br /> <br />2 341.00 applicaton fee <br />2 904.00 quarry application <br />1 938.00 amendment fee <br />_ 2 344.00 conversion fee <br />Qffire d <br />Active and Inatlive Mines <br />