PERMFILE101618

• Permit No: M2004048
• IBM Index Class Name: Permit File
• Doc Date: 9/3/2004
• Doc Name: Adequacy Response
• From: Daub & Associates
• To: DMG
• Media Type: D
• Archive: No

TATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
Department of Natural Resources
1313 Sherman St., Room 215
Colorado 80203
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Phone: [phone] ~
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FAX: (303)s3z~8106 CONSTRUCTION MATERIALS
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I.IIVIITED IMPACT (110) OPERATION v % O
1tECLAMATIONPEI2MITAPPLICATIONFORM ~ ~ '°
DiV/SION OF
MIN&RALS
-6-£-E3 L O G Y
RECLAMATION
MINING•SAFE7Y
O " 8111 Owens
- p Governor
Creg E. Walther
CHECK ONE: There b a FUe Number Already Assigned to this Operation Eaecuuve oirectrrr
' ~ ~ ~ ~ Ronald W. Gaany
Permit # ~vI -_-_-_ (Please reference the file number currently assigned to this operation) Aping Division Director
X New Application (Rule 1.4.5) Amendment Application (Rule 1.10)
Converaiott Application (Role 1.11)
Permit # ~vI_-_- _ (provide for Amendments and Converalona of existing permits)'
The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the
application foffi; (2} Exhibits A-J, Exhibit L, Addendum i, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the
Office, and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.62(1)(b); and (3) the application fee. When yon submit your application, be sure to
include one (1) complete sued sad notarized IVORY ORIGINAL and one (1) copy of the completed Ivy applicatioaform, two (2) copies
of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geoteclniical Stability Exhibit), as requited, and a check for the
application fee descrbed render (4) below. Exhibits should! 1OT be boned or in a 3-ring binder, maps should be folded to 8 1!2" X 11" or
8 1!2" X 14" size. To expedite processing, please provide the information in the format and order described in this form.
GENERAL OPI~2ATION INFORMATION
Type or print clearly, in the space provided, ALL information described below.
1. Anolicant/ooerator or mmoanvname (name to be used on Hermit): Robert DauohertY
1. ] Type of orgamza4on (corporation, parbiership, etc.):
Individual
1.2 I.R.S. Tax ID No. or Social Security Number. 2.:
2. Onerationname(nlt.mineorsitenamel: Cedar Point Picture Rock Quarry
3. Pern»tted acreage (new or eaistine site):
~ /, S" T~ permitted acres
3.1 Change in acreage (+) 0 . 0 acres
3.2 Total Acreage in Permit Area yJ~ ~,,,$~ ~ acres

4. Fees
4.1 New Application: $1.094.00 application fee
Amendment Fee (C.RS. 34-32.5-125(11)): $719.00 application fee
4.2 ConversionFee (from I lOdto 110 $875.00 conversion fee (Rule 1.112(2))
5. Primarvcommoditie(altobemined: Decorative Stone/Rock
5.1 Incidental commoditie(s) to be mined: 1. 100 1bX/Tons/Lr 2. / Ibs/I'ons/vr 3. / lbs/Tonslvr
4. / Ibs/I'ons/vr 5. / Ibs/Tonsixr
5.2 Anticipated end use of primary commoditie(s) to be mined:
Anticipated end use of incidental commoditie(s) to be mined:
Tables, Countertops, Furniture
Landscape Stone and/or Reclamation