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<br /> <br />~~ <br />CONSTRUCTION MATERIALS <br />C, <br />OF COLORADO <br />RECEIVED D I V 151 D N O E <br />MINERALS <br />APR U 5 2000 ~` <br />GEOLOGY <br />0.ECLA NATION <br />Division of Minerab & Geology MINING • S A F E T Y <br />LIMITED IMPACT (110) OPERATION <br />eil I Owens <br />Governor <br />Greg E. Walther <br />RECLAMATION PERMIT APPLICATION FORM E~ecurive Director <br />Michael B. long <br />Divicio" Dueclor <br />CHECK ONE: ~ New Application (Rule 1.4) Conversion Application (Rule 1.11) <br />Amendment Application (C.R.S. 34-32.5-110) <br />Permit ay ~-_ ; V (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major pans: (1) the application form; <br />(2) Exhibits A•1, Exhibit L, Addendum 1, arty sections ofExhibit 6.5 and Geotechnical Stability Exhibit, az required by the Office, and outlined in Rules <br />6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(6); and (3) the application fee. When you submit your application, be sure to include one (1) comolete si e¢n d and <br />rtotarized IVORY ORIGINAL and one (1) copy of the canpleted vo application form, two (2) copies of Exhibits A-],Exhibit L, Addendum 1, and <br />appropriate sections of 6.5 (Geotechnical Stability Exhibit), az requtred, and a check for the application fee described under (4) below. Exhibits should <br />NQ be bound or in a 3-ring binder, maps should be folded to 8 12" X l l" or 8 12" X 14" sue. To expedite processing, please provide the informarion <br />in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information described below. <br />1. Aonlipodooentor or comoatrv Dame (name to be used o0 oermitl: Kiowa County <br />1.1 Type oforganiution (corporation, partnership, etc.): Government <br />' L2 LR.S. Tax ID No. or Social Security Number: <br />2. Ooention name (wit, mine or site namel: <br />3. Permitted acreage anew or existing sitd: <br />3.1 Change in acreage (+) <br />Total Acreage in Permit Area <br />4. Fees <br />9.5 permitted acres <br />acres <br />acres <br />4.1 New Application: _5875.00 application fee <br />Amendment Fee (C.R.S. 34-32.5-125(il)): 5575.00 application fee <br />4.2 Conversion Fee (from I I Od to 110 875.00 conversion fee (Rule ].11.2(2)) <br />5. Primary commoditie(s) to be mined: Gravel <br />5.1 Incidental commoditie(s) to be mined: I . ! Ibs/fons/vr 2. / Ibs/fons/vr 3. / IbslTons/vr <br />4. / Ibs/fons/vr 5. / Ibs/fons/yr <br />5 ~ Anticipated end use of primary commoditie(s) to be mined: Road Material <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />OlV1S{ON OF MINERALS AND GEOLOGM <br />Uepstmenl of Natural Resources <br />1713 Sherman St., Room 2i5 <br />Denver. Colorado 80?03 <br />Phone: (3031 866-3567 <br />FAX: (303)tl32-B1U6 <br />Schmidt Gravel Pit <br />