Laserfiche WebLink
, STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ~~ <br />Department of Natural Resources <br />7313 Sherman S(., Room 275 <br />Denver, Colorado 80203 DIVISION o F <br />Phone: (303) 866-3567 RECEa\/ED MINERAL $ <br />FAX: (303) 832-8106 ~ & <br />~t~~~2~ GEOLOGY <br />t-ONSTRUCTION MATERIALS RECLAMATION <br />FILE COPY MINING•SAFETY <br />REGULAR (112) OPERATION <br />AMATION PERMIT APPLICATION FO IRM n of Minerals and Geology sat Owens <br />FOR SCANN/lam" Governor <br />Greg E. Walther <br />Executive Director <br />CHECK ONE: XR New Applicafion (Rule 1.4.5) _ Amendment Application (Rule 1.1 ichael B. Long <br />ivision Director <br />Conversion Application (Rule 1.11) <br />Permit # M -2 ®~ - f l7- -_ (provide for Amendments and Conversions of e~s6ng permits) <br />The application for a Construction Materials Regulaz 112 Operation Reclamation Permit contains tlu'eemajor pazts: (1) the application form; <br />(2) Exhibits A-S, Addendum I, any sections of Exhibit 6.5 (Geotechnical StabilityExhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete siened and notazized IVORY ORIGINAL and four (4) copies of the completed Ivorv <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sectons of 6.5 (Geotechnical Stability Exhibit, and a check for the . <br />application fee described under Secfion (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" <br />or 8 1/2" X 14" size. To expedite processing, pleaseprovide 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 requested below. <br />1. Applicantloperator or company name (name to be used on permit): Seifert Constrncti nn <br />1.1 Type of organization (corporafion,paztnership, etc.): Sole Proprietorship <br />1.2 LR.S. Tax LD. No. or Social Security Number: -84--966•~~5- g ~- 0(0 ~ ~ ~ ~ -S S ~ ~G' <br />2. Operation name (nit, mine or site name): <br />Permitted acrea¢e (new or existin¢ site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />Fees <br />t GD permitted acres <br />acres <br />acres <br />4.1 New Applicaflon $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 operafion (set by statute) $2.344.00 conversion fee <br />Primary commoditie(s) to be mined: Sand ~ravPl Tnpgn; 1 _ <br />5.1 Incidental commoditie(s) to be mined: 1. - Ibsffons/vr 2. / Ibs/Tons/ <br />3. / lbs/pons/vr 4. / lbs/I'ons/vr 5. / lbslTons/vr <br />5.2 Anticipated end use of primary commoditie(s)tobemined:Base Course, Concrete & Asphalt. Aggre¢ate Topsoil <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />