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STAT OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY .L/ <br />Deparonent of Natural Reraaecn <br />1313 Sherman St„ Room 215 C O L D RAD O <br />Denver, Colorado 80203 <br />1307)8667567 <br />Phone <br />CONSTRUCTION MATERIALS DIVISION o r <br />MINERAL S <br />. ~ <br />FAX: (303) 832a1a6 REGULAR (112) OPERATION G E O L O G Y <br /> RECLAMATION PERMIT APPLFCATION FORM `~iei~i~1OC,e~,ce"` <br />eat o»r~ <br />Goemw <br />CFff.CK ONF. There is a FBe Number Already Auigued to fhb Operatba Rouen 0eorae <br />Petmu # t~v -_ _-_ (Please reference the file number currently assigned to this vpttauon) t"C°'I^'° Dtreaor <br />X Rwld W. Cwny <br />New Apphcaion (Rule 1 4 5) _ Amendment Apphcaion (Rule 110) wnaw+w,rnv <br />_ Coovenion Apphcauon (Rule 111) wwd Resou¢e r~1a <br />Yermtt # M -_ _ _ (pmt~de for Ameadrnenb and Coaverabna of cxrsung permits) <br />The apphcation for a Constntchon Matenais Regular 112 tJperationReciamation Perms contetns dvec mayor parts. Q) the apphcation (prin. <br />(2)ETlubtts A-S, Adrkndum 1, any sections ofExhtbn 6.6{Geotecltmcel5tabdtty F.xhtbn; and (3)the apphcation (ee When you subtrutyour <br />apphwuon, be sure to include cote (I) complete stoned and notarized ORIGINAL and one (I) copy of the completed apphcation fain, two (2) <br />copses of Exhtbrts A-S, Addendum i, appropnate sections of6 S (Geotech»icel Smbthty EXlubrt, end a check for the application fee desmbed <br />under Section (4)below EXhtbus shotild~be bound ormalmngbinder, maps shouldbe folded to8l/2"X ll'or812'X I4"stze To <br />expcdne pnxesstng, please provide the udormatton m the format and order descnbed m this form <br /> CrENERAL OPERATION INFORMATION <br /> Type or pr1o1 clearly, iu the apace provided, a~ information rsquested Debw. <br /> / <br />SIIt Sand & Gravel <br />LLC r / <br />I AoD licaat/ooeratororwmoaov name (name to berated on DermitY , <br />FF// <br /> 11 Type oforgazuzauon (corporeuan, partnerstup, etc) Limited Liability Comp any <br />2 ODe ratbnname(oit.mineoraReDame) Grand River Park Project <br />3 Permitted acreaee (Herr or existine aNe)~ <br />~D 163 permuted acres <br /> 3 ! ~ <br />Change m acreage (+) RECEI / acres <br /> 3 2 ','Wal aurwge m Permti area MAY ~ 7 ~~ ,V// 163 aa~ <br />4 Fees <br /> 4 I New Application <br />rata sad GaoloOY <br /> 4 2 New Quarry Apphwhon Division of Mine g2 906.00 ~uarry pphcanon <br /> 4 4 Amendment Fee S 1.938.00 amervhnent fee <br /> 4 S Convennon to 112 opttattun (set by statute) 52.344.00 convttston fee <br />i Prbn arv rnmmodhie(al [o be mined sand gravel <br /> 5 I Inetdental cornmaltbe(s) to be mined 1 ]bs?umlvr 2 / lbs/)'ons/yr <br /> 3 / !bs/I'ons/vr 4 / Ibs/Cons/K 5. / Ibs/fonsNr <br /> 52 AnhmpatedenduseofpnmaryoommaLhe(s)tobemined construction agp reQateS <br /> 5 3 Anuapated end use of incidental commorlthe(s) to be rnened N/f1 <br /> Office of Office of Colorado <br /> Mined Land Reclamation Active and Inacdre Mines Grologidl Sane/ <br />