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TATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY / <br />Department of Natural Resources <br /> <br />7313 Sherman SL, Room 215 ~~`re E'v E® <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS qpR 2 3 20pq v <br />FAX: (303) 832106 <br />FILE P Y LnKITED IlOIPACT (110) OPERATION '~ <br />/per R /`~/g_~d A~A~ /~I//~~ 'LAMATION PERMIT APPLICATION FO tRM n of Minerals and GeoloBY <br />CHECK ONE: There is a File Numbe~Already Assigned to this Operation <br />Permit # M -20 0 ~_-Q'7 (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4.5) <br />Amendment Application (Rule I.10) <br />Conversan Application (Rule 1.11) <br />Permit # M - -_ (provide for Amendments and Conversions of existing permits) <br />COLORADO <br />DIVISION O F <br />MINERALS <br />GEOLOGY <br />0.ECLA NATION•MINING <br />SAFETY•SCIENCE <br />Bill Owens <br />Governor <br />Greg E. Watcher <br />Executive Director <br />Ronald W. Canany <br />Division Director <br />Natual Resourm Trustee <br />The application foraConstructionMaterialsLimitedImpact(110)OperationReclamationPerrnitmniainsthreemajorpalts: (1)theapplication <br />form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exbibit, as required by the Office, and <br />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 to include one <br />(I) complete limed and notarized IVORY ORIGINAL and one (1) copy of the completed I~ application fomt, two (2) copies of Exhibits <br />A-J, Exhibit L, Addendum I, and appropriate sections of 6.5 (Geotechtucai Stability Exhibit), as required, and a check for the application fee <br />described under (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to S 1/2" X 11" or 81/2" X 14" size. <br />To expedite processing, please provide the informmtion in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, m the apace provided, ALL information described below. <br />Aoolicant/oceratororrnmnanvname(nametobenaedoncermitl: AZCO Construction. Inc. <br />1.1 Type oforganization (corporation,partnec~sbip,etc.): Colorado Corporation <br />1.2 1.2 1.RS. Tax ID No. ar Social Security Number: R4 _] (12.3()14 <br />2. Oneration name (oit, mine or site eame): AZCO P i t <br />3. Permitted acreage (new or eaistine site): a • 9 permitted acres <br />3.1 Change in acreage (+) acres <br />3.2 Total Acreage in Permit Area acres <br />4. Fees: , <br />4.1 New Apglicaiion: 1094.00 application fee <br />Amendment Fee(C.R.S.34-32.5-125(Il)): 719.00 application fee <br />4.2 Conversion Fee (from 110d to 110 $875.00 conversion fee (Rule 1.11.2(2)) <br />5. Prmtarvcommoditie(a)tobemined: Sand ravel <br />5.1 Incidental commoditie(s)tobemined: 1.NnnF! 1bs/Tons/~r 2. / Ibs/fons/vr 3. / ]bs/Tons/vr <br />4. / lbslTons/vr 5. / (bs/fonsl~ <br />5.2 Anticipated end use ofprimatycommoditie(s)tobemined: Road Material & Construction Aggregates <br />Anticipated end use of incidwtal commoditie(s) to be mined: None <br />C~ce of Office of Colorado <br />Mined Land Reclamation ARive and Inactive Mines Geological Survey <br />