Laserfiche WebLink
'~OOS OS/ <br />CONSTRUCTION MATERIALS <br />LIMITED IMPACT (110) OPERATION ~/ <br />RECLAMATION PERMIT APPLICATION FORM <br />RECEIVED <br />JUN f 18005 ~ <br />mil ~f INiaerals ]md GelU~yy <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Permit # M -_ _ _ (Please reference the file number currently assigned to this operation) <br />~ New Application (Rule 1.4.5) Amendment Application (Rule L10) <br />Conversion Application (Rule 1.11) <br />Permit # M - (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Limited hnpact (110) Operation Reclamation Permit contains three major pans: (1) [he <br />application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections ofExhibit 6.5 and Geotechnical Stability Exhibit, as required by <br />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 <br />to include one (1) comole[e siened and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies of <br />Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the <br />application fee described under (4) below. Exhibits should NOT be bound or m a 3-ring binder; maps should be folded to 8 ]Yl" X 11" or 8 <br />112" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATTON INFORMATION <br />Type or print clearly, in the space provided, ALL information described below. <br />I. Avolicant/overator or comnanv name (name to be used on vermitl: V. Pdul MO1tZ /ACA Produc~Inc. <br />1.1 Type of organization (corporation, partnership, etc J: Pri vatP <br />1.2 I.R.S. Tax ID No. or Social Security Number: <br />2. Overation name fvit, mine or site name): River Park Recreation Access <br />3. Permitted acreage (new or existing sitel: 9.96 permitted aces <br />3.1 Change in acreage (+) acres <br />3.2 Total Acreage in Permit Area 9.96 acres <br />4. Fees: <br />4.l New Application: 1 094.00 application fee <br />Amendment Fee (C.R.S. 34-32.5-]25(II)): 719.00 application fee <br />4.2 Conversion Fee (from I lOd [o I10 875.00 conversion fee (Rule 1.11.2(2)) <br />5. Primary commoditie(s) to be mined: Rnnl r3PrG Cnhhl a (:raval <br />S.l Incidental commoditie(s) to be mined: 1. ! IbslTonslvr 2. J IbslTonshr 3. / 16slTonslvr <br />4. / Ibs/Tons/vr 5. / Ibs/fons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: R2Claiilatl0ri / COristructlOri Material <br />Anticipated end use of incidental commoditie(s) to be mined: <br />