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r ~~' ~"°' III IIIIIIIIIIIII III <br />999 <br />~TAT~ OF ~ !ADO <br />DIVISION OF MINERALS AND GEOLOGY rr~~ rr~~ f; g nrttt <br />Depar~ment or ,vatural Resourc _s UE1. C S 2[:C9 `\~ <br />I } I } Shermpn it.. Raom 715 <br />Denier. CO~Or.]d0 IIO?o3 pivision oS Minerals and Geal gq I v 15 I O v <br />Phone: UoA J66-7567 CONSTRUCTION ~~LaTERL4LS ~~t I N E RA I <br />F,',x ua)l e}~ elce REGUL,+.R (112) OPER4TI0`i &- <br />RECLAr~L4TION PER,~IIT APPLICATION FOR~~I . ~~ ~ G E O L O G <br />R ECL~IHA7~C <br />' <br /> ~ A <br />`r ~l ra u3 {~, ~~M c ~D ~orST <br />CHECK ONE. There is a File Number Already Assigned to this Opera o (', ~ ~~ <br />~ s E. walche' <br />Pzrmrt ° ~(~r~,r 1 (Plzaiz reT'zrence thz filz numbzr curt n Ex°~""tee o"ea°' <br />!~~chael 9. long <br />New Application (Rule L-t.5) _ Amendment Application (Rulz L 10) o,.~tron o~reuor <br />Convesioo .4pplicauo^ (Rutz 1.11) <br />Permit ~ M -_ (provide for Amendments and Coovenioos of zxisting pzrmiu) <br />Thz application for a Cotrstrucdon Materials Regular 112 Operation Rzclamation Permit contains threz major parts: (I) the application form; <br />(2) Exhibits .4-S, Addrndr>m 1, any sections of Exhibit 6.5 (Geotechtaical Stability E.xhrbir and (3) the application fee. When you submit your <br />applica[ioR be sure to include one (1) complete si®ed and notarized IVORY ORIGI`rIAL and four (4) copies of the completed Ivory <br />application form, five (i) copies of Exhibits A-S, Adderadum 1, appropriate sections of 6.5 (Geotechrrical Stability Exhibit, and a chick for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder, maps should be folded to <br />8 I/2" ~ ! I" or 3 I/2" ;C 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the (pace provided, all information described below. <br />1.1 Type of organization (corporation, partnership, etc.): r~ n n R ~-: ~ n/ <br />1.2 [.RS. Tax I.D. No. or Social Szcuri[y Number: ~/-~ ~ • /. <br />2. Operation Dame (nit, mine or rite name): <br />3. Permitted acreage (new or eaisting she1: <br />3.I Change in acreage (+) <br />3.2 Total acreage in Permit area <br />~. Fees: <br />4.I Nzw Application <br />4.2 New Quam Application <br />4 d Amendmzn[ Fee <br />4S Conversion toil? opzration (set by statute) <br />(p ~-a) ~ r D~ e eta ~ . S permitted acres <br />aces <br />acres <br />S2,3d.t 00 application fie <br />52.906.00 quarry application <br />S 1.938.00 amendment fez <br />S2.3a1.00 conversion fee <br />d. Primary commoditie(sl to be mined: ~" ~ E ~ ~~. A7 .$,ZijN~° <br />~ I Incidrntal commoditie(s) to bz miazd: L / IbyToas/vr ?. / Ibs(IoasPor 3. / lbs~Ioaslvr <br />s. / Ibs/1'oas/vr ~. / Ibs/foaslvr <br />i 2 Anticipated end use of primary commoditie(s) to be trained: .~ ~ N /~ ~il1 R PF ~- (~ .: /~ ',yg ~) l-n Nc <br />5.3 Anticipated end rue o[ incidental commodine(s) to be trained: RPM ~~~ a E, n~i r=; // <br />