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II I I II I II I II IIII III ~ ~ a,~~~, eo <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources R~r <br />131 3 Sherman St.. Room 215 • ' "' ~ ~ ~ ~ ~ D <br />DIVISION O F <br />Denver, Colorado 80203 <br />Phone 13031 866 3 567 CONSTRUCTION MATERIALS MAR t" a ~?^i`~ MINERAL S <br />FAX. (3031 8328106 ~ & <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION F G E O L O G Y <br />Q~IOn of Minerals and Geology a E C L A M A T I O N <br />MINING•$AFETT <br />BJI pwens <br />Governor <br />CI-IECK ONE: There is a Finnle fN,umber Already Assigned to thi+ Operation Greg E. Wakher <br />Permit # M -~1---`/ ~ LL' (Please reference the Fde number currently assigned to this operation) E.ecuuve O~reuor <br />X M~chaelB Long <br />New Application (Rule 1.4.5) _ Amendment Appltcatton (Rule 1.10) D~~~:.on oueclor <br />Conversion Application (Rule 1.1 l) <br />Permi[ # M -_ -_ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhrbits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhrbit; and (3) the application fee. When you submit your <br />applicatioq be sure to include one (!)complete si>med end notarized IVORY ORIGINAL and four (4) copies of the completed No <br />application form, five (5) copies of Exhibits A-S, Addendum I, appropriate sections of 6.5 (Geatechnical Stability Exhibit, and a checA for <br />the application fee described under Section (4) below. Exhibits should NOT be bound ar in a 3-ring binder, maps should be folded to <br />8 I/2" X 1 L" or 8 1f2" X 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 space provided, all information described bebw. <br />1. AoplicanUooerator or romoanvname (Dame to be used on permkl: <br />Aggregate Industries, IJest Central Region, Inc. <br />1.1 Type of organization (corporatioq partnership, etc.): OOrpOrd t'IOn <br />1.2 I.RS. Tax I.D. No. or Social Secttrity Ntnnber: 84-0404340 <br />2. Operation name (nit, mine or site name): FfBdStrOm R080U rC0 <br />3. Permitted acea¢e (new or e:istin¢ si(te): 266 permitted acres <br />3.1 Change in acreage (+) acres <br />3.2 Total acreage in Permit azea 266 acres <br />4. Fees <br />4.1 New Application $2.344.00 application fee <br />4.2 New Quarry Application $2,906.00 quarry application <br />4.4 Amendment Fee $1.938.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) $2.344.00 conversion fee <br />~. Prrm arv commoditie(s) to be mined: Sand Gravel <br />5.1 Incidental commoditie(s) to be mined: 1. / Ibs/fons/vr 2. / Ibs/Coos/vr 3. / Ibs/Tons/vr <br /> 4. / lbslfoos/vr 5. / Ibs/fons/vr <br />5.2 Anticipated end use of primary commodi[ie(s)to be mined: COnStrUCt'IOn MdterldlS <br />5.3 Anticipated end use of incidental commoditie(s) to be [Wined: <br />