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iECEl~ED <br />ocr z ~ Z~o2 5-rATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY era s and Geology <br />Department of Natural Resources L~i <br />1313 Sherman $t., Room 216 <br />Denver, Colorado 00203 <br />Phone: 13031866-3567 CONSTRUCTION MATERIALS <br />FAX: (3031 03 2-01 06 REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Permit # M - 92 -066 •_ (Please reference the file ntunber currently assigned to this operation) <br />DIVISION O F <br />MINERALS <br />GEOLOGI' <br />RECLAMATION <br />MINING•SAFETY <br />Bill Owens <br />Governor <br />Greg E Watcher <br />Executive Director <br />Michael B. Long <br />_ New Application (Rule 1.4.5) ~ Amendment Application (Rule 1.10) Division Director <br />_ Conversion Application (Rule 1.1 l) <br />Permit # M -_ (provide for Amendments and Conversions 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) Exhtbits A-S, Addendum 1, any sections of Exbibit 6.5 (Cmotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete sued and notarized IVORY ORIGINAL and four (4) espies of the wmpleted Ivory <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />[he application fee described under Section (4) below. Exhibits should NOT be bound or 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 this form. <br /> GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. AoolicanUooerator or rnmoanv Dame (name to be used on permit): <br /> DUCKELS CONSTRUCTION, INC <br />1.1 Type of organization (corporation, parmership, etc.): CORPORATION <br />1.2 I.RS. Tax I.D. No. or Social Security Number: <br />2. Oseration name (nit, mine or site Hamel: HOGUE RIVER PIT <br />3. Permitted acreage (new or eaistine site): 52.74 permitted acres <br />3.1 Change in acreage (+) . 00 acres <br />3.2 Total acreage in Permit azea 52.74 acres <br />4. Fees: <br />4.1 New Application $2.344.00 application fee <br />4.2 New Quarry Application $2,906.00 quarry application <br />4.4 Amendment Fee $1.938.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) $2.344.00 conversion fee <br />5. Prim ary commoditie(s) to be mined: GRAVEL <br />5.1 Incidental commoditie(s) to be mined: 1. / IbslTons/vr 2. / lbs/Tons/vr 3. / lbs/Tons/vr <br /> 4. / lbs/Tons/vr 5. / 1bs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) [o be mined: USED IN THE CONSTRUCTION INDUSTRY <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />