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~~, aoo7- o0 7 <br />STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY pppp~~~~ RR''-- <br />• Department of Nawral Resources f ~ ~}.. C [C ~ ~ /~ 1'1 -~ <br />1713 Sherman 5t., Room 275 1 ~ 2, ~~(~tf ' "V 4,~ ~J !„J/ C O L O R A D O <br />Denver, Colorado 80203 V-16 ~ A 2007 <br />JAN 't I nice stoN or <br />er,one;i3o3)1we-3s57 ~ ~ RECLAMATION <br />vex: i3o3) s32stoa Division of Reclamation, M [ N I N G <br />~'' Mining and Safety sac try <br />CONSTROCTION MATERLILS <br />LIM1TITF <br />D IMPACT <br />I10 <br />OPERATION e:u cM~M,: <br />( <br />) <br />, Guvemo: <br />RECL.4VfATION PERMIT AYPLICATtON FORM a~~Mti c«,rsd <br /> tx~~Aivr. Plreaor <br />Ronald w. Cananv <br />CfiE_CK ONF.: 'There is a File Number Already Assigned [o this Operation txvision oirecSer <br />~atmal Re»wcc Trvafx <br />Pem»f k FI -_ _ ~ (Please reference the file number currently assigned to this operation) <br />X New Application (Rule 1.4.5) ,__ Atnendnten[ Application (Rule 1.10) <br />Conversion Application (Rule t.l I ) <br />Permit ff _M -~ ~ (provide for Amendments and Conversions of existing permits) <br />Ttte application for a Construction Materials Limited Itt~act (I 10) Operation Reclamation Permit contnins three major parts: (I) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit G.5 and Geotechnical Stability Exhibit, as required <br />by the OfFce, and otttlined in Rules 6.1, 6.2, 6.3, 6.5, and I .G.2(I)(b): and (3) the application fee. LVhen you submit your application, be <br />sure to include one (I) complete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies <br />of Exhibits A-J, Exhibit L, Addendnnt I, attd appropriate sections ofG.S (Georechnical Stability F,'xhibit), as required, and a check for <br />the application fee descnbedunder(4) below. Exhibits should NOTbe bound or in a 3-ring binder; maps shouldbe folded to S ]/2" X <br />t l" or 8 V2" X I4" size. To expedite processing, please provide the information in the format and onler described in this farm. <br />' GENERAL OPERATION I'VFORMATION <br />Type or print clearly, in the space provided, ALI. information described below. <br /> i <br />t. App licantloperator or company name (name to be used on permit): t"tu 11 e t t ExC a ya t i n g , LL,^,~~ <br /> L 1 Type of organization (corptma[ion, partnership, etc.): L i m i t e d_ L i a b i l i. t y C o m p a n y ___ <br />2. Operation name (pit, mine or site namel: MOOneV H111S Permit . <br />J. Permitted acreat-e (pew or existing aife): 10 _ permitted acres <br /> 3.1 Change in acreage (~~) __~ acres <br /> 3.2 'total Acreage in Permit Area ______ acres <br />4. Foes: <br /> 4.1 New Application: 31 094.OU application ["ee <br /> Atnertdtnesni Fee (C.RS. 34-32.5-125(II)): __$?t9.00 application tee <br /> 42 Conversion Pee (from ] lOd w 1 10 .875.00 conversion tea: (Rule 1.1 1.2(2)) <br />5. Primarrcomrttoditie(sitobemined:• road base, aUQregate, fill material <br /> S.1 incidental comnmditic(s) to be mined; L _ Ibs/'fous.~ 2. ________ Ibs~Tonsfvr 3. ___ r Ibs'fons.wr <br />4. / _Ibs.%`I'ons%vc 5. _ /___ Ibe~Tons~ <br />5.2 Anticipated end use of primary•conrtnoditie(s)ta 6e nuned: road~ba Se, aq[fretlate, fill material ; <br />Anticipated end use of utcidental commoditie(s) to be mined: __,_.._.________„___________.~~____----.___.. ~' <br />• i <br />OHiiv u( Office of j <br />Minrd Lahti Rrx'Iamalion ACTive atx) Ina<tice Mines <br />