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REV104791
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REV104791
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Entry Properties
Last modified
8/25/2016 1:16:13 AM
Creation date
11/22/2007 1:20:55 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1999069
IBM Index Class Name
Revision
Doc Date
9/19/2005
Doc Name
Construction Materials Regular (112) Operation Reclamation Permit Application Form
From
Jake Kauffman & Son Inc.
To
DMG
Type & Sequence
AM1
Media Type
D
Archive
No
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-S- <br />Maoa and E:hibip: <br />Two (2) complete, unbound application packages must be submitted. One complete application package consists of a signed application fomt <br />and the set of maps and exhibits referenced below as Exhibits A•S, Addendum 1, and the Geotechnical StabihTy Exhibit. Eachexhibitwithmrhe <br />application must be presented as a separate section. Begin each exhibit on a new page. Pages should be numbered consecutively for ease of <br />reference. If separate documents are used as appendices, please reference these by name N the exhibit <br />With each of the two (2) signed application forms, you must subari[ a corresponding set of the maps and exhibits as described in the following <br />references to Rule 6.4, 6.5, and 1.6.2(1 Xb): <br />EXFIIBff A Legal Description <br />E3GBBIT B Index Map <br />EXI-IIBIT C Pre-Mining and Mining Plan Map(s) of A$'ected Lands <br />EXHIBIT D Mining Plan <br />EXHI$iT E Reclamation Plan <br />EXI II$IT F Rcclaroation Plan Map <br />EXHIBIT G Water Information <br />EXHIBIT H Wildlife Information <br />EXHIBIT I Soils Information <br />EXHIBIT J Vegetation Information <br />EXHIBIT K Climate Information <br />EXHIBIT L Reclamation Costs <br />EXHIBIT M Other Permits and Licenses <br />EXHIBIT N Source of Legal Right-To-Enter <br />EXHIBIT O Owners of Record of Affected Land (Surface Area) and Owners of Substance to be Mined <br />EXFIIBIT P Municipalities Within Two Miles <br />EXHIBIT Q Proof of Mailing of Notices to County Commissioners and Conservation District <br />EXHIBIT R Proof of Filing with County Clerk or Recorder <br />EXHBIT S Permaramt Man-Made Structures <br />Rule 1.6.2(1)(6) ADDENDUM I -Notice Requirements (sample enclosed) <br />Rule 6.5 Geotechnical Stability Ex}ribit (any required sections) <br />The instructions far preparing Exhibits A-S, Addendum 1, and Geotechnical Stability Exhibit are specified under Rule 6.4 and 6.5 and <br />Rule 1.6.2(1 xb) of the Rules and Regulations. If you have any questions on preparing the Exhibits or content of the information required, or <br />would like to scMdule apre-application meeting you may contact the OSrce a[ 303-566-3567. <br />Responsibilities as a Permittee: <br />Upon application approval and permit issuance, this application becomes a legally binding document. Therefore, there are a <br />number of important requirements which you, as a permittee, should fully understand. These requirements are listed below. <br />Please read and initial each requirement, in the space provided, to acknowledge that you understand your obbgations. Ifyou do trot <br />understand these obligations then please contact this Office for a full explanation. <br />1. Your obligation to reclaim the site is not limited to the amoum of the financial warranty. You assume legal <br />liability for all reasonable expenses which the Board or the Office may incur to reclaim the affected lands associated <br />with your mining operation in the evert your permit is revoked and fmancial warranty is forfeited; <br />
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