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~cE,TE OF COLOI~~~ <br />DIVISION OF MINERALS AND GEOLOGY Cn + <br />Department of Natural Resources yly 06 ~JJ7 REWEIV€~ ~•~r' ~_ <br />1313 Sherman St., Room 215 I VI I V JJI •; I~~~~ <br />Denier, Colorado 80203 :( <br />Phone: (303) 866-7567 ~~ ~} ~ 1[107 J• <br />FAX: (3031 832-8106 DI416bh of Minaralc x ugolga~ ` 1•i/ <br />DEPARTMENT OF <br />~~"~1°°° ~i~n or M~naral` a ul~e~6py NATURAL <br />LIMITED IMPACT OPERATION (110) RESOURCES <br />RECLAMATION PERMIT APPLICATION PORM ~~ ~ Roy ROmI•! <br />Governor <br />I+mes 5. lochhearl <br />E.ecuiwe Dnecwr <br />Michael B. Long <br />Dis+s~on Unranr <br />CAECR ONE: X New Application (Rule 1.4) Aseadaeat Application (C. R.S. 34-32.5-110) <br />Conversion Application (Rule 1.11) <br />Permit ~ N// -~~-~~-_ (provide for Aoendsents and Conversions of <br />7'~ existing permits) <br />The application for a Construction Materials Limited Impact Mining (110) Operation Reclamation <br />Permit contains three major parts: (1) the application form; (2) Exhibits A-J and Exhibit L, <br />Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the <br />Office, and outlined in Rules 6. 1, 6.2, 6.3, and 6.5; and (3) the application fee. when you <br />submit your application, be sure to include one (1) complete sinned and notarized IVORY ORIGINAL <br />and one (1) copy of the completed ivory application form, two (2) copies of Exhibits A-J and <br />Exhibit L, appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check <br />for the application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring <br />binder; maps should be folded to 8 1/2" X 11" or 8 1/2" X 14" size. To expedite processing, <br />please provide the information in the format and order described in th}s foroyA~ _ ~r~~ <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/operator or company name (name to be used on permit): <br />Moonscape Partners llp <br />1.1 Type of organization (corporation, partnership, etc.): a9rtne rshlp <br />1.2 I.R.S. Tax ID No. or Social Security Number: ..3 ~ ' '~'"~tl ~ 0~~~ ~ <br />2. Oceration name (pit, mine or site name): <br />Moonscape Pit <br />3. Permitted acreaoe (new or existing site): Y•'/ permitted acres <br />3.1 Change in acreage (+ or -) acres <br /> Total Acreage in Permit Area •~ acres <br /> <br />4. Fees: <br />4.1 New Application 5875.00 application fee <br /> Amendment Fee (C.R.S. 34-32.5-125(II)) 5575.00 application fee <br />4.2 Conversion Fee (from 110d to 110 5875.00 conversion fee (Rule 1.11.2(2)) <br />5. Primary commoditie(s) to be mined: Sand Gravel Solls <br />5.1 Incidental commoditie(s) to be mined; 1. - lbs/Tons/vr <br /> 2. / lbs/Tons/yr 3. / lbs/Tons/vr <br /> 4. / lbs/Tons/vr 5. / lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: R oad base~Flll <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: N/A <br />