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- ~ oo y ~si/ STATE OF COLORADO <br />DIVISION OF MINERAfS AN D GEOLOGY RECE <br /> <br />Department of Natural Resources IVE D <br />73135herman St., Room 275 <br />D <br />nv <br />r <br />Col <br />d <br />30203 / COLORADO <br />JUL 1 4 2004 o I v I s t o N o r <br />, <br />ora <br />o <br />e <br />e <br />Phone: D03) 36G3567 R <br />CONSTRUCTION MATERIALS MINE <br />FAX: (303) 832706 S <br />REGULAR (112) OPERATIOIpivision of Minerals and Ge31ogY G E O L O G Y <br /> RECLAMATION PERMIT APPLICATION FORM RFCU NATION•NIN ING <br />TAf ETYRQENCE <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Bill Owens <br />Covemor <br />Russell Geroge <br />Permit >x M ~- ~5 -_ (Please reference the file number curreidy assigned to this operatiofi)e"mire Director <br />R New Application (Rule h.4.5) ~ ,Amendment Application (Rule 1.10) Ronald w. wtrany <br />Division Diratrn <br />Conversion Application (Rule 1.11) Natural Resoum Trustee <br />Pemtit # M - -_ (provide for Amendments and Conversions of existing pemtits) <br />The application for a Constmction Materials Regulaz 112 Operation Reclamation Pemtit contains twee major parts: (1) the application <br />form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Ex]ubit; and (3) the application fee. When you <br />subvtit your application, be sure to include one (I) complete signed and notarized I VORY ORIGINAL and one (1) copy ofthe completed <br />Ivory application form, two (2) copies of Exhibits A-$ Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a <br />check for the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be <br />folded to 8 I /Z" X 1 ] " or 8 t/2" X 14" size. To expedite processing, please provide the information in the format and order described in <br />this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />1. Aoolicant/ocerator or comaanv name name to be used on Dermitl: pggroga rP TnAnetriac - W('Rf Tne <br />L1 Type of organization (corporation, partnership, etc.): Corporation <br />1.2 I.R.S. Tax I.D. No. or Social Security Number <br />2. Operation name (pit, mine or site name): Wattenberg Lakes / <br />3. Permitted acreage (new or existing site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit azea <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primarvcommoditie(sltobemined: Aggregate <br />5.1 Incidental commoditie(s) to be mined: 1. _ n/a - Ibs/Tons/Kr <br />3. / 1bsfI'onslvr 4. ! Ibsll'ons/vr <br />420.8 permitted acres <br />- acres <br />420.8 acres <br />$2.344.00 application fee <br />$2.906.00 quarry application <br />$1.938.00 amendment fee <br />$2.344.00 conversion fee <br />2. / Ibsfl'ons/vr <br />5. / Ibs/fons/vr <br />5.2 Anticipated end use of primary cormnoditie(s)tobernined: Construction materials <br />5.3 Anticipated end use of incidental commoditie(s) io be mined: n / a <br />Office of C~ce of Colorado <br />Mined Land Reclamation Active and Inactive Mines Geological Survey <br />