2004-06-30_PERMIT FILE - M2004048

• Permit No: M2004048
• IBM Index Class Name: Permit File
• Doc Date: 6/30/2004
• Doc Name: Application
• From: Robert Daugherty
• To: DMG
• Media Type: D
• Archive: No

l-~oOy-p~~t/
STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
Department of Natural Resources
1313 Sherman St., Room 215
Denver, Colorado 80203
Phone: [phone]
FAX: [phone]
CONSTRUCTION MATERIALS
FILE
fOR

RECE!.VED DIVISION OF
UN3p2904/ MINERALS
-G-E E~ L O G Y
COPY I'Il111TED IMPACT (110) OPERATION metals & GeotoO R E C L A M A T I O N
9iyiS1en el M~ MINING•SAFETY
SCANN/II i~~ATION PERMIT APPLICATION FOBM
CHECK ONE: There is a File Number Already Assigned to this Operation
Permit # M -_-_ ~ -(Please reference the file number cturently assigned to this operation)
X New Application (Rule 1.4.5) ~ Amendment App]ication (Rule 1-10)
Conversion Application (Kale 1.1 I)
Permit # M - (provide far Amendments and Conversions of existing permits)
Bill Owens
Governor
Greg E. Walther
Executive Director
Ronald W. Cottony
Acing Division Director
The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the
application farm; (2} F,xhrbits A-7, EXhtbit L, Addendun 1, a~ sections of Exlulrit 6.5 and Geotechnical Stabrlfly Exhibit, as required by the
Office, and outlined in Itnles 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(6); and (3) the application fee. When yon sabmit your application, be sure to
include one (I) complete signed and notarized IVORY ORIGINAL and one (1) copy of the completed h'019 apphcationfomi, two (2) copies
of Exhrbits A-7, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotecluucal Stability Exhibit), as required, and a check for the
application fee descnbed ender (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" or
8 1/2" X 14" size. To expedite processing, please provide the information in the format and order descrbed in this form.
GENERAL OP1~2ATION INFORMATION
Type or print clearly, in the space provided, ALL information described below.

1. Applicant/ooeratororcomnanyname(nametobeusedonnermit): Robert Daughert y
1.1 Type of organization {corporation, partnership, etc.): I n d i v i d u a l
1.2 I.RS. Tax ID No. or Social Security Number: 2.:
2. Operation name (pit. mine or site name): Cedar Point Picture Rock Quarry /
3. Permitted acreage (new or eaistin¢ site): 9 . 3 pemutted acres
3.1 Change in acreage (+) 0 .0 a<;res
3.2 Total Acreage in Permit Area 9 . 3 acres
4. Fees:
4.1 New Application: $1.094.00 application fee
Amendment Fee(C.R5.34-32.5-125(II)): $719.00 application fee
4.2 Com~ersion Fee (from 110d to 110 $875.00 conversion fee (Rule 1.11.2(2))
5. Primary commodhtie(s)tobemined: Decorative Stone/Rock
5.1 Incidental commoditie(s) to be mined: 1. 10 0 lbx/'Ions/yt 2. 1 lbslTons,'vr 3. / lbs/Tousivr
4. / lbs/Tons/vr 5. / Ibs/Tons/vr
5.2 Anficipatedendnseofpr~arycommoditie(s)tobemined: Tables, Countertops, Furniture
Anficipatedenduseofincidentalcotnmoditie(s)Tobemined: Landscape Stone and/or Reclamation