PERMFILE104446

• Permit No: M1999029
• IBM Index Class Name: Permit File
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT 110 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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OF COLORADO
" DIVISION OF MINERALS AND GEOLOGN [~
Uepsrmem of Natural ReSOUrces r~~C~l1i_f
1313 Sherman St., Room 115 V L~ D I v 1 5 I O N O r
Denver, Colorado 80?O7
Phone: [phone] i'' ~~( ~1 _ i:~,n, MINERAL 5
FAK 1303) 83?-8106 &
' Division of Minerals 6 Geology G E O L O G Y
R E C L A M A T I O N
MINING•SAFETY
CONSTRUCTION MATERIALS
Bill Owens
LIMITED IMPACT (110) OPERATION Governor
Greg E. Walther
RECLAMATION PERMIT APPLICATION FORM Execunve Director
Michael B. Long
Division Director
CHECK ONE: X New Application (Rule 1.4) Conversion Application (Rule 1.1 l)
Amendment Application (C.R.S. 34-32.5-110)
Permit # v~l -_ _-_ (provide for Amendments and Conversions of existing permits) {~(~ (~
The application far a Corlswction Materials Limited Impact (] 10) Operation Reclamation Permit contains three major parLS: (I) the application form;
(2) Exhibits A-], Exhibit L, Addendum ],any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the Office, and outlined in Rules
6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be sure to include one (1) comolete si eng d and
notarized IVORY ORIGINAL and one (1) copy of the completed lvorv application form, two (2) copies of Exhibits A-J, Exhibit L, Addendum 1, and
appropriau sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the applicatioi fee described under (4) below. Exhibits should
NOT be bound or in a 3-ring binder, maps should be folded to 81R" X 11" or 8 1R" X 14" siu. To expedite processing, please provide the information
in the format and order described in this form.
I r GENERAL OPERATION INFO1tMAT10N
Type or print clearly, in the space provided, ALL information described below.
Apoliunt/operator or company name (Dame to be used on cermitl:
l .l Type of organization (corporation, partnership, etc.):
1.2 I.R.S. Tax ID No. or Social Security Number: _
2. Operation name foit, mine or site name]:
Lo(;an County
County Government

Rob Terrill Clav Pit
3. Permitted acreaee (new or e:istine site]:
3.1 Change in acreage (+)
Total Acreage in Permit Area
4. Fees:
4.1 New Application:
Amendment Fee (C.R.S. 34-32.5-125(il)):
4.2 Conversion Fee (from I 1 Od to 110 875.00 conversion fee (Rule 1.11.2(2))
5. Primary commoditiNsl to be mined: C1aY
9.96 permitted acres
acres
9.96 acres
875.00 application fee
$575,00 application fee
5.1 Incidental commoditie(s) to be mined: 1.16.000 >tb6lfons/ALC 2. / Ibs/fonslvr 3. / Ibs/fons/vr
4. / Ibs/fons/vr 5. / Ibslfons/vr
5.2 Anticipated end use o(primary commoditie(s) to be mined: C1aV to line & cover County landfill cells
5.3 Anticipated end use of incidental commoditie(s) to be mined: None