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' 1 <br />1 <br />1 <br /> <br /> <br />1 <br />1 <br />DIVt5101v OF,vtI~VE,2.',15.~,ND GEOLOGY QC <br />Dr'Partme•v rn Natural Rrsuurcei <br />I f l S ~hennen $i., Nnum _' 1 r SEP 1 <br />Drm'er. lulurado 9U.!13 n <br />Ptinne:liU it 96ii-}5n7 J 00 <br />~.~x:,lo;l all nlao <br />CREIGIiLAR (I lo) OPERaTIOnOrMt~ a~8 Ga0p9Y <br />RECLAV(ATION PERl11T APPLICATIOY FORS( <br />' The application For a Construction Mazerials Regular I l2 Operation Reclamation Permit contains three major parts: (I) the appficarion form; <br />(2) Exlubia A-S, Addendum 1, arty sections ofExluba 65 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (I) comolete sitmed and notarized IVORY ORIGI`!AL and four (4) copies of the completed Ivory <br />' application form, Eve (S) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibi4 and a check 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 />8 112" X 11" or 8 l2" X l4" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERA!. OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />' 1 <br />2. <br />3. <br />i 1 <br />~\~ <br />OI VISION Of <br />~~1[NERALS <br />GEOLOGY" <br />a E C L .1 " A. I C N <br />YININ G'iA F¢.Y <br />ylll (]w.m <br />Cuvernnr <br />acres <br />56.06 acres <br /> New Application SI.87S.00 application fee <br /> 4.2 New Quarry Application S?.325.00 quarry applicarion <br />' 4.3 <br />4.4 Iv(illingApplication(Non-DMO) <br />Amendment Fee 53.100.00 <br />S 1.550.00 milling application <br />amendment fee <br /> 4.5 Conversion to I l2 operation (set by statute) Sf.875.00 conversion Fee <br />'S. Primary commoditie(sl to be mined: Sand 5 Grave 1 <br /> 5.1 Incidental commoditie(s) to be mined: I. N/A Ibs/fonslvr 2. 1 Ibsl1'onslvr <br /> i. / Ibsl1'ons/vr 4. / Ibs(['ons(vr 5. f 1 6slfons/vr <br />' 5.2 Anticipated end use of primary commoditie(s)tobemined: GOnstruetion materials <br /> S3 Anticipated end use of incidental commoditie(s) to be mined: N/A <br />56.06 pertninedacres <br />Crr; E, wal<Ser <br />c.vecvuve Onecror <br />CHECK ONE: Yew A lication Rule 1.4.5 Amendment A lication Rule 1.10'v;~h'el e. Lone <br />Conversion application (Rule 1.1 ! ) <br />Permit ~ :~f -_ _ (provide for Amendments and Conversions of existing permits) <br />AoolicanVooentororcomoanvnamefnametobeusedonoermit):Beayer5 Construction/Hizh Mesa Grave <br /> <br /> <br />Ooerationname(oit.mineorsitenamel: High Mesa Gravel Pit <br />Permitted acreaee (new or ezistin~ site!: <br />3.1 Change in acreage (+) <br />31 Total acreage in Permit area <br />t 4. Fees <br />4.1 <br /> <br />STATF, ~F_COLOIZP~DO <br />