PERMFILE100334

• Permit No: M2001088
• IBM Index Class Name: Permit File
• Doc Date: 8/23/2001
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT 110 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

III IIIIIIII11111111 •
STATE OF,
DIVISION OF MINERALS AND GEOLOGY
Deparrmen[ of Natural Resources
1313 Sherman St., Room 215
Denver, Colorado 80203
Phone: [phone]
FAX: [phone]
CONSTRUCTION MATERIALS
LI)NITED IIKPACT (110) OPERATION
AUG 2 3 2001
Division of Minerals and
RECLAMATION PERMIT APPLICATION FORM
~~
DIVISION Ok~
MINERALS.
GEOLOGY
0. EC LAMATION
MI NING•SAFETY
Bill Owens
Governor
CHECK ONE: _ ` There is a File Number Already Assigned to this Operation
Greg E. Walther
Executive Director
Michael B. Long
Permit # M - 00 -~ _ (Please reference the file number currently assigned to this operation) D+~+s+on D.re<lor
New Application (Rule 1.4.5) _ Amendment Application (Rule 1.10)
Convenioa Application (Rule 1.11)
Petit # M -_ (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Limited Impact (1IO) Operation Reclamation Petit contains three major parts: (I) the
application form; (2) Exhibits A-J, Exhtbtt L, Addendum 1, any sections of Exhibit 6.5 and Geotcehnical Stabiluy Exlubi[, as squired by the
Office, and outlined m Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(6); and (3) the application fce. When yon submit your application, be sure to
include one (1) cumulate sued sod notar¢ed IVORY ORIGINAL and one (1) copy of the completed Ivat apphcation form, two (2) copies
of Exhibits A-J, Exhibit L, Addendum 1, end epptopriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the
application fee described ceder (4) below. Exbibits should NOT be bound or in a 3-ring border, maps should be folded to 8 I/2" X 11" ar
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 punt ckariy, in the space provided, ALL information described below.
1. AnnlicanUooerator or eomoanv name foame to be used on oermkl:
C~•~eY .Qil/OE,~L E ~o~sr~euGr/oc% ~~/~/,.
L l Type of organization (corporatio0. partnership, etc.): ~~/-DO/-"4 T7 D/)
1.2 I.RS. Tax ID No. or Social Security Ntrmber: 2.: ~~ l 20,5 7/Q
2. Ooeratioo name tort. mine or site name]: yPL~~~~ ~~~~'~~
3. Permitted acrcaee tnew or esvetine ettel: ~ ~~ permitted acres
3.1 Change in acreage (+)
Tote! Acreage m Permit Area
4. Fees
~ acres
acres
4.1 New Application: S 1.094.00 application fee
Amendment Fee (C.R.S. 34-32.5-125(II)): 5719.00 application fee
4.2 Conversion Fce (from I 1 Od to 110 8S 75.00 conversion fee (Role 1.11
2(2))

S. Prim
ary eommodinerel to be mined: /'Q~'C~ SQ~d ~i
/
~[/ ~~ Co66~rs
5.1 Incidentilcommoditie(s)Wbemined: 1. ! Ibs/fonsJvr 2. ! {bslfonslvr 3. / lbs/Ions/vr

4. / Ibs/1'oos/vr 5. / Ibs/I'ons/vr

5.2
Anticipated end use of primary commoditie(s) to be mined:
~OIL~ ,(~ILSC~ - `
L ~~~SCCj~ e

Anticipated end use of incidental commoditie(s) to be mined: /VO/7 e