PERMFILE108642

• Permit No: M2005039
• IBM Index Class Name: Permit File
• Doc Date: 5/19/2005
• Doc Name: regular operation Reclamation Permit Application Form
• From: dmg
• To: bent county
• Media Type: D
• Archive: No

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STATE OF COLOI~DO
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DIVISION OF MINERALS AND
Department of Natural Resources GEOLOGY ` +
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1313 Sherman St., Room 215 C ~ ]., 0 RA jJ 0
Denver, Colorado 80203
Phone: [phone] CONSTRUCTION MATERIALS
,
/ / MAY 7
~ ZC~S D I V I S I O N o r
MINERAL S
FAX: (303) 832$106 REGULAR (t 12) OPERATION ,
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RECLAMATION PERMIT APPLICATION FORM .
' a[ctenAnoN•nININc
SAFETY•SLIENCE
CHECK ONE: There is a Fik Number Already Assigned to this Operation
Petlnit # bI -_ ` , (Please reference the file number currently assigned to this operation)
1~ New Application (Rule 1.4.5) _ Amendment Application {Rule 1.10)
Conversion Application (Rule 1. I I )
Permit # M -~ _ (provide for Amendments and Conversions of existing permits)
Blll Owen$
Gwemor
Greg E. Walther
Executive Director
Ronald W. Canany
Division Director
Natural Resource Trustee
The application for a Conshuetion Materials Regular 112 Operation Reclamation Permit contain, three major parts: (I) the application form;
{2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 {Geotechnical Stability Exhibit; and {3) the application fee. When you submityour
application, be slue to include one (1) complete signed and notarized IVORY ORIGINAL and one (1) copy ofthe completed Ivor application
form, two (2) copies of Exhibits A-S, Addendum I, appropriate sections of 6.5 (Creotechnical Stability Exhibit, and a check for the application
fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder, maps should be folded to 81/2" X 11" or 812" X
14" size. To expedite processing, please provide the information in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, ALL information requested bebw.
I . Aoolicaet/onerator or comoanvname (name to be used on txrmitj: ;~ EJJ T C o ~t N T y
l .l Type of organization (corporation, partnership, etc.): C~ ~o ov ER u nn EN'T
1.2 I,R.S. Tax I.D. No. or Social Security Number: R Ht -~ to D oo s7' hr !n
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2. Operation name (nit, mine or site name):
R'= 'D I..1. P ~ T
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3. Permitted acreatre (new or er,istiutt site]: ci 3 . l 8 permitted acres
3.1 Change in acreage (+) acres
3.2 Total acreage in Permit area 9 ~ • J $ acres
4. FF=s:
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4.1 New Application $2 344.00 application fee
4.2 New Quarry Application $2.906.00 quarry application
4.4 Amendment Fee $[.938.00 amendment fee
4.5 Conversion to 1 ] 2 operation (set by statute) $2 344.00 conversion fee
~
5. Prim arc commoditie(s) to 6e mined: S R N D Co R A V E S ~"R O CK
5.1 Incidental commoditie(s) to be mined: 1. Ibs/TonsA~ 2. / Ibs/TonshT
~
3. / ibs/fons/vr 4. / IbslTons/vr 5. / IbslTons/vr
5.2 Anticipated end use of primary commoditie(s) to be mined: " R o q a M A Y E R x R L
5.3 Anticipated end use of incidental commoditie(s) to bemired:
Office of Office of Colorado
Mined land Reclamation Active and Inactive Mines Geological Survay