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V1- 2co4' Ol ~ <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of NaNral Resources <br />1313 Sh <br />R <br />215 <br />S ~'~r~„ ~~~~ <br />• <br />erman <br />t., <br />oom <br />Denver, Colorado 80203 L <br />AAw <br />CEIVED <br />Phone: (303) 866-3567 ~~'~ <br />`LH <br />f~R <br />FAX: (303) 832-8106 V <br />FEB 2 6 2004 <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATIONDivision ~f Minerals and Geology <br />RECLAMATION PERMIT APPLICATION FORM <br />DIVISION OF <br />MINERALS <br />GEOLOGY <br />RECLAMATION <br />MI NING•SA FETY <br />Bill Owens <br />Governor <br />Greg E. Walther <br />Executive Director <br />CHECK ONE: X New Applicaion (Rule 1.4.5) _ Amendment Application (Rule 1.1 ichael e. Long <br />ivision Director <br />Conversion Application (Rule 1.11) <br />Permit # M - - (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Ivlaterials Regulaz 112 Operation Reclamaflon Permit contains three major pazts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical StabilityExhibit; and (3) the applicaton fee. When you submit your <br />application, be sure to include one (1) complete siened and notarized IVORY ORIGINAL and four (4) copies of the completed Ivorv <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the . <br />applicaflon 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" <br />or 8 lY2" X 14" size. To expedite processing, please provide [he information in the forma[ and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />1 <br />Auolicantloperator or company name (name to be used on permit): Trans Colorado Concrete, a Div. of Pete Lien <br />1.1 Type of organization (corporation, paztnership, etc.): Corporation <br />1.2 LR.S. Tax LD. No. or Social Security Number: <br />2. Operation name (pit, mine or site name): St. Barbara Sand and Gravel Mine <br />3. Permitted acrea¢e (new or e7dstine site): 364 permitted acres <br /> 3.1 Change in acreage (+) acres <br /> 3.2 Total acreage in Permit azea 364 acres <br />4. Fees: <br /> 4.1 New Application $2.344.00 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) $2.344.00 conversion fee <br />5. Primary commoditie(s) to be mined: sand gravel <br /> 5.1 Incidental commoditie(s) to be mined: 1. None - lbs/Tons/vr 2. / Ib s/Tons/vr <br />3. ! lbs/Tons/vr 4. / lbs/I'ons/vr 5. / lbs/Tons/vr <br />5.2 Anticipated end use ofprimazycommodifie(s)tobemined: Construction Aggregate and Concrete Aggregate <br />5.3 Anficipated end use of incidental commoditie(s) to be mined: None Anticipated <br />& Sons, Inc <br />