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ECEEVE® ~-l~R~--~o~ <br />ocr 2 e 2002 ~-rATE OF COLORADO <br />' 'siea of fAinarals an8 Gea egy - <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 D I v 15 1 0 N O t <br />Denver, Colorado fl0203 <br />Phone: (3031 866-356 CONSTRUCTION MATERIALS MINERAL 5 <br />FAX: (303) 832-8106 REGULAR (112) OPERATION s` <br />GEOLOGY <br />RECLAMATION PERMTT APPLICATION FORM a E c L A M A T i o N <br />MINING•SAF ETY <br /> <br />Bill Owens <br />Governor <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Greg E. Walther <br />Permit # M - c~2-~-_ (Please reference the file number currently assigned to [Eris operation) Executive Director <br />Michael 9. LOng <br />_ New Apphcation (Rule 1.45) ~(_ Amendment Application (Rule 1.10) Division Director <br />- Conversion Application (Rule 1.1 Il <br />Permit # M - - (provide For Amendments and Copversions of existing permits) <br />The application for a Construction Materials Regulaz 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendum I, a~ sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete siened and notarized IVORY ORIGINAL and four (4) espies of the wmpleted Ivory <br />application form, Sve (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound a in a 3-ring binder, maps should be folded to <br />8 1/2" X 11" or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in [his form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />I. AppGcant/operator or rnmpanv name (name to be used on permit): <br />n k 1¢ Cnnetrnctl on TnC <br />1.1 Type of organization (corporation, partnership, etc.): <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: _ <br />2. Operation name (pit, mine or site name <br />~'~Jb <br />3. Permitted acreaee (eew or eaistine site): ~/~' _52.74 permitted acres <br />3.1 Change in acreage (+) 0 saes <br />3.2 Total acreage in Permit azea p/LA _ 52.74 _ aces <br />4. Fees: <br />4.1 New Application $2 344.00 application fee <br />4.2 New Quam Appbcation $2.906.00 quarry application <br />4.4 Amendment Fee $1.938.00 amendment fee <br />4.5 Conversion to 112 operation (se[ by statute) $2.344.00 conversion fee <br />~. Prim ary commoditie(s) to be mined: Gravel <br />5.1 Incidental commoditie(s) to be mined: 1. ! Ibs/Ions/vr 2. / ]bs/TonsPor 3. / lbs/Tons/vr <br /> <br /> 4. / lbs/Tons/vr 5. / 1bs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s)tobemined: used in the Construction Industry <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />