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STATE OF COLORADO <br />DIVISION OP RECLAMATION, MINING ANp SAFETY <br />pepartment of Natural Resources <br />1313 Sherman St., Room 215 REC EIV <br />IJerner, Colorado 80203 O R A D O <br />n 1 4 f 5 1 0 N O F <br />Phone: (303) 8663567 DECLAMATION <br />fA%: (3037832~t06 AU~ Q 9 2~ ( MINING <br />GRAND JUNCiiON rfE1 OFfJQ~ ETY <br />CONSTRUCTION MATERIALS DIVISION OF <br />RECLAMATION MINING ~~~S~F~sY <br />LI1Vli1"F,D IMPACT (I10) OPERA'f[ON Grrr«rmr <br />RECLAMATION PERMIT APPLICATION FORM Rurell Georse <br />Eae[utive ~irttlor <br />Ronald W. Cattany <br />CIiECK ONE: There is a File Number Already Assigned to this Operaflon oiri:ion o;renu, <br />Natural Resource Tru<lee <br />Permit ft M -o ' ^ ~-t (Please reference the file munber cogently assigned to this operation) <br />New Application (Rule 1.4.5) Antendmeut Application (Buie LLO) <br />Conversion Application (Rule i.I q <br />Petmif Y K -~ `_ -_ (provide for Amendments and Conversions of existing permits) <br />The application For a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (I) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum I, gay seGions of Exhibit 6.S and Geotochnieal Stability Exhibil; as required <br />by the Office, and outlined in Rules 6.1, 6.2, 6.3, G.S, and 1.6.2(I)(b); and (3) the application fee. When you submit your application, be <br />sure w include one Q } w~lete simed and notarized ORIGINAL and one (1) copy of the competed applioation Corm, nvo (2j copies <br />of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for <br />the application fee described under (4) beiocv. Exhibits should NOT be bountt or in a 3-ring binder; maps should be folded to S I f2" X <br />11" or & 1!2" X l4" size. To expedite pmcessing, 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 iuformation described below. <br />L <br />1.1 Type of organization (corporatioq parhlelshiq etc.): l~L\X,11CtE V~AQfVIC~-l V <br />2. Operation name (pit, mine or site Dame): <br />3. Permitted acreage fntw or existing site): permitted saes <br />3.1 Change in acreage (+) ~- acres <br />3.2 Total Acreage in Permit Area ~ ~ acres <br />4. Fees: <br />4. i New Application: S! 094.00 application fee <br />Amomhnent Fee (C_R.S. 34-32.5-125(II)): $?19.00 application fee <br />4.2 Corrvtrsion Fec (from I lOd to 110 X75.00 conversion fee QZUIe 1.1 L2(2j) <br />S. Primary rnmmoditie(s1 to be mined: /~~C_ ~~. ~~~I.FJ-~_ __, <br />S. ] Incidental commoditie(s) to be mined: 1. Ibs,`Tonsi 2. ~Pos/Tons/vr 3. '~T- Ibs/Tons/vr <br />4. -_~"'r lbs(fmts'vr 5. .-h--~ Ibsr"fonsivr <br />S.2 Anticipated end use of primary commoditie(s) to be mined: ,u_~~7 I '-I-`--`" <br />Anticipated end use of incidental commoditie(s) to be nuncd: ~,_g,Q_~5~~-~l~.t~,.Se1 <br />Offim of Office of <br />Mined Land RixaamatiOn Active and Inactive Mines <br />