REV101983

• Permit No: M1986074
• IBM Index Class Name: Revision
• Doc Date: 3/10/1997
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT OPERATION 110 RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: SO1
• Media Type: D
• Archive: No

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STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
Depanment o(Natural Resources I~~~~
1313 Sherman St., Room 215
Denver, Colorado 80203 (`, r ~v ED
Phone: [phone] RF
FAl(: [phone]
CONSTRUCTION MATffitIALS.pR '~ Q 1997 ~ DEPAR77viEI~TI'OF
II''II NATURAL
LI1[ITED IMPACT OPERATION (110) RESOURCES
RECLAlWTION PSR1fZT APPI~~{~vi~~' h U~01ea~ Roy Romer
Wvemor
lames 5. Lochhead
Executive Director
Michael B. Long
Division D~renor
CFIECR ONE: Nelr Application (Rule 1.4) Amendment Application (C. R.S. 34-32.5-110)
Conversion Application (Rule 1.11)
Permit ~ - -_ (provide for Amendments and Conversions of
existing permits)
The application for a Construction Materials Limited Impact Hiniag (110) Operation Reclamation
Permit contains three major parts: (1) the application form; (2) Exhibits A-J and Exhibit L,
Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the
Office, and outlined in Rules 6.1, 6.2, 6.3, and 6.5; and (3) the application fee. When you
submit your application, be sure to include one (1) complete sinned and notarized IVORY ORIGINAL
and one (1) copy of the completed ivory application form, two (2) copies of Exhibits A-J and
Exhibit L, appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check
for the application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring
binder; maps should be folded to S 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.
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GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, all information described below.
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1. A licant o rator or co anI name name to be used on rmit
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1.1 Type of organization (corporation, partnership, etc.): (--~rlt L+ liT o.
1.2 I.R.S. Tax ID No. or Social Security Number: sue- 9(, - 7 S
2. Operation name (pit, mine or site name): .VO ~~C'~CYI~~ ~t

3. Permitted acreage (new or existing site): permitted acres
3.1 Change in acreage (+ or -) acres
Total Acreage in Permit Area ~ acres
4. Fees•
4.1 New Application S875.00 application fee
Amendment Fee (C.R.S. 34-32.5-125(II)) 5575.00 ~ application fee
4.2 Conversion Fee (from 110d to 110 65 75.00 conversion fee (Rule 1.11.2(2))
5. Primary colmtloditie(sl to be mined: ~'
5.1 incidental commoditie(s) to be mined: 1. - lbs/Tons/vr
2. / lbs/Tons/vr 3. / lbs/Tons/vr
4. / lbs/Tons/vr 5. lbs Tons r
5.2 Anticipated end use of primary commoditie(s) to be mined: o Se
5.3 Anticipated end use of incidental commoditie(s) to be mined: