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CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Permit # M --_ _ (Please reference thefile number currently assigned to this operation) <br />New Application (Rule 1.4.5) %Amendment Application (Rule 1.10) <br />Conversion Application (Rule I.11) <br />Permit # M -1(1Q¢_ll]_6_-_ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (I) the application <br />form; (2) Exhibits A-S, Addendum t, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) 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 or in a 3-ring binder; maps should be folded to <br />8 1/2" X 1 1" or 8 I/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 requested below. <br />Applicant/operator or comaany name (name to be used on permit): Lafarge West ~ Inc . <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />] .2 I.R.S. Tax I.D. No. or Social Security Number: <br />2. Operation name (pit, mine or site name): Riverbeitd Operation <br /> <br />3. Permitted acrea¢e (new or existing site): 437 permitted acres <br />3.1 Change in acreage (+) 931 acres <br />3.2 Total acreage in Permit area 1 ,36 ~ acres <br />4. Fees: <br />4.1 New Application $2344.00 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) $2.34490 conversion fee <br />5. Primary commoditie(sl to be mined: Sand Gravel Fill <br />5.] Incidental commoditie(s) to be mined: 1. NA - Ibs/Tons/vr 2. / Ibsll'ons/vr <br /> 3. / Ibs/Tons/vr 4. / Ibs/Tons/vr 5. / Ibs/Tons/vr <br />52 Anticipated end use of primary commoditie(s) to be mined: Construction Materials <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: NA <br />