REV103537

• Permit No: M1994011
• IBM Index Class Name: Revision
• Doc Name: TABLE OF CONTENTS
• Type & Sequence: CN1
• Media Type: D
• Archive: No

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DEPARTMEI~fT' OF
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CONSTRUCTION MATERIALS
REGULAR OPERATIONQ(YL3Qi)ulr.dnt~a'ouuc0I09Y
RECLAMATION PERMIT APPLICATION FORM
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Governor
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CHECK ONE: New P.pplication (Rule 1.4.5) __ Amendment Application (Rule 1.10)
_ X Conversion Application (Rule 1.11)
Permit f P1_ 94 _ 011 _(110)(provide for Amendments and Conversions of
existing permits)
The application for a Regular 112 Operation Reclamation Permit contains three major parts: (1)
the application form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical
Stability Exhihit; and (3) the applicatior. fee. When you submit your application, be sure to
include one (11 complete sinned and notarized IVORY ORIGINAL and four (4) copies of the completed
ivor1r application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate aectiona of 6.5
(Geotechnical Stability Exhibit, and a check for the application fee described under Section (4)
below. Exhibits should not be bound or in a 3-ring binder; maps should be folded to 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.
GENERAL OPERATION INFORMATION
Type or print clearly in the space provided the information requested below.
1. Applicant/operator or company name (name to be used on permit):
__ __ WEST END GRAVEL ~Q~KpANY
1.1 Type of organization (corporation,.partnerahip, etc.): _ CORPORATION
1.2 I.A.S. Tax I.D. No. Or Social Security Number:
2. operation name (pit, mine or site name): "WEST END GL~AVEL PIT N"_L'_
3. Permitted acreage (new or existing site) 9.9 permitted acres
3.1 Change in acreage (+ or -) 29.5 acres
3.2 Total acreage in Permit area 39.4 acres
4. Fees:
4.1 New Application 51,875.00 application fee
4.2 New Quarry Application 52,325.00 quarry application
4.3 Milling Application (Non-DMO) O 53,100.00 milling application
G.G Amendment Fee C?IECK N-.-_- _-- 51,550.00 amendment fee
4.5 Conversion to 112 operation (set by statute)EIdCLOSED: 51,875.00 conversion fee
5. Primary convnoditie(sl to be mined:
5.1 Incidental commoditie(s) to be mined: l.EARTH R0240W - 7000±~fhisE/Tons/vr
2. GOLD / 100± nz.Y~/T3(i)S7~/vr 3. ! ibs/Tons/vr
4. / lbs/Tons/vr 5. / 1bs/Tons/vr
5.2 Anticipated end use of primary commoditie(s) to be mined: A(;GRFGATE_
5.3 Anticipated end use of incidental commoditie(s) to be mined: EMBAr)'-SENT