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,~_ ~~,~ ~,~ ~~f STATE OF COLQRADC <br />DIVISION OF MINERALS AND GEOLOGY l./' ^r <br />"~ ~~ Department d Natural Resaurres rm (~V~ <br />73735hrmon SL, Room 215 e'rS~,9 ~ COLORADO <br />Denver, Colorado 80203 DIVISION O F <br />phone: (303) 8663567 CONSTRUCTION MATERIAIS M I N ERA L S <br />FAX: (3031 63 2-07 06 REGULAR (111) OPERATION ~ G E O L O G Y <br />RECI.AMATIONPERMTTAPPLICATIONFORM "E: IETY!ECIEN'CEN` <br />all ONlflf <br />Elaerrar <br />CHECK ONE: `There i+ a Fik Number Already Assigned to thG Operation <br />Russell Geaga <br />Permit # M -,_ -~ (Please reference the file number cmrentty assigned to this operation) Fneanive oi,ea« <br />Ronald W. Gaany <br />XX New Application (Rule 1.4.5) _ Amendment Application (Rule 1.10) Div;aton Din:clar <br />Conversing Application (Rtile 1.11) Natuni Resource 7rvsta <br />Permit # M -; _ (provide for Amendmegta and Cogvera7ooa of existing permits) <br />The application for a Construction Materials Regttlat 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections ofExbibit 6.5 (Geotec)mical Stability Exhibit, and (3) the application fee. When you subtttityols <br />eppiication, be sure to include one (1) comniete sib and notarized ORIGINAL amd one (I) copyofthe compir.Ked application forth, two (2) <br />copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (l.reotechnical Stability Exhibit, and a check for the application fee described <br />under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; (naps should be folded [0 8 I /2" X l l" or 8 t/2" X 14" size. To <br />exp,xlite procesvigg, please provide the ird'onna[ion in the format and order described in this form <br />GENERAL OPERATION RdFORMAT]ON <br />Type or print clearly, iq the spare provided, ALL information requested below. <br />'• Moffat County Board of County Commissioners t~- <br />1. ADDlicantlocentor or comoanvname (name to be used on permitl: <br />].1 Type oforgenization (corporation, parinersbip, etc.): - T,OCal Government <br />2. ODeratbnname(Dit.mineoraiteDame):State Pit NO. 38 <br />3. Permitted acreaae (new or eaietinn site): <br />3. f ('hange in a¢eage (+) <br />3.2 7bta1 ac7eage m Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry AppliE:alion <br />4.4 Amendment Fee <br />4S Conversion to ] 12 operation (set by statute) <br />5. Psimarvrnmmoditiefs)tobemined: Sarid <br />43.320 petmittedaaes <br />~~~~r~~® <br />c3ov o 1 zoos / <br />pivis;nn or Reclamation, <br />a,Nning and Safety ~~ <br />reed h~ ~ <br />acres <br />43.320 acres <br />XXX $2.344.00 application fee <br />$2.906.00 quarty application <br />$I 938.00 amendment fee <br />$2 344.00 conversion fee <br />Gravel Clay <br />5.1 Incidental cotnmaditie(s) to be mined: 1. N/A ]bs/ron s/vr 2. N/A~ IbslTons/vr <br />3. N~A ! lbs/fons/,~r 4. N~~' lbs/fon slvr . 5. N~A / Ibslfons/v7 <br />52 Antici ated ens rase of ri commoditie(s)tobemined' Road Maintenance Materials <br />P P ~Y <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: N~A <br />Office of Office of Colorado <br />Mined land Reclamation ARlve and Inactive Mines Geological Survey <br />