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M - ~o 0'7- add ~ <br />STATE OF COLORADO <br />DIYISION OF RECLAMATION, MINING AND SAFETY Z~ <br />Department of Natural Resources -r ~ ' <br />1313 Sherman St., Room 215 ~~~® ~~~,~1U~~ ~,` ~/~(/, ~ ~~i~.Pt C O L O RA D O <br />Denver, Colorado 80203 (~ ~ A-`~ - ~° f ~ p., i s i ~ N o r <br />Phone: (34316663567 C,"r"~ ~j~-,,"s,. oo'' CONS7'RtiCTCON MA'fERCALS Jq~ 'fiF~AMATION <br />FAX: 13031 832-8 1 06 ~+>{" Q ®`' ~,. )~:G11LAR (112) OPERATION p/~/ 22?O 4 ~ &NG <br />`(~~ RF.G`LTION PECLdIIT APPLICATION FOR,M1)~sro0 of ~ SAFETY <br />I/ \~aStPf\RtaPd~pa tntn9ahasam-„~"o---- <br />@ M)~ta@ afetyea~'~ s <br />cavemor <br />CHECK ONF: There is a Fite Numbor Already Assigned to this Operation Russell cxirrgr <br />Permit N ~ --~ __ (Please reference the fife number currently assigned [o this opera"'" Director <br />RonaM N'. Cathry <br />New Application (Rule 1.4.$) _ Amendment Application (Rule L10) Dm(sbn Dinxta <br />`Conversion Application (Rule L 11) Narurzl Rawurce Tmsree <br />Permit N ~i -_ -_ {provide for Amendments and Conversions of existing pemtitsj <br />The application for a Construction Materials Regular 1 l2 Operation Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A-S, Addendmn 1, any sections of Exhibit 6.$ (Geotecbnical Stability Exhibit; and (3) the application fee. Whon you <br />submit your application, be sure to include one (1) co» lplete sianed and notarized ORCGINAL and one (1) wpy of the completed <br />application form, two {2) copies of Exhibits A-S, Addetrihun 1, appmpriaic sections of 6.$ (Geotecbnical Sability Exhibit, ands check for <br />the application fee described under Section (4) below. Exhibits should NOT bo bound or in a 3-ring binder; maps should be folded to <br />8 1I2" X 1 I" or 8 1/2" X t4" size. To expedite processing, please~mvide thethe information in the format and order described in this form <br />GENERAC, OPERATION CNF'ORMATION <br />Type or print clearly, in the <br />1. i Type of organization (corporation, parhtership, etc.): <br />2. Operation Dame (nit, mind or site Hamel: <br />3. Perm iNed acreage fneav or exfstins sitel: <br />3.1 Qhange in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Foes: <br />4.1 NewAppiica[ian <br />~t2 New Quarry Application - <br />4.4 Amendment Fee <br />4.,5 fonversion to 1 I2 operatirnr (set by sta <br />ane) <br /> I <br />$. Prlmar'Y.Cnminndltle(a) LOl eZ.mine¢: j <br />5.1 tncidental commoditie(sj to be mined: 1. __ <br />3. ___ / _ IbstTons/vr 4. <br />$.2 Anticipated and use of pritrmry commoditie(s) to be mined: _ <br />$.3 Anticipated end use of incidental commoditie(s) to be nilmd: <br />INfite of <br />Mined Land Rctilamarion <br />information roquesKed blow. <br />~..~ ~ ~ <br />~~ permitted acres <br /> <br />~ acres <br />52.344.00 <br />2 906,00 <br />~~j~ 81.93R.00 <br />!-`~~ -~2 344.(! <br />_ acres <br />appteca[ion fee <br />quarry application <br />amendment fee <br />conversion fee <br />2, Fbsffons/vr <br />Office of <br />Active and Inatliae Mines <br /> <br />