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<br />Gi:'i t ~ c~C'1 <br /> <br />Dlvisinn of Minerals and Geology STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources `~ <br />1313 Sherman SL, Room ?t ~ <br />Denver, Colorado x0203 <br />Phone: (303) 866-3567 ,,. f,('1 CONSTRUCTION MATERIALS <br />FAx: t3o31 a3?-ato6 , (f ~ REGULAR (112) OPERATION <br />~~ RECLAMATION PERMIT APPLICATION FORM <br />M~~ <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Permit # M -c~~l- O~7-_ (Please reference the fde number cnrreutly assigned to this operation) <br />X New Application (Rule 1.4.5) ! Amendment Application (Rule 1.10) <br />`Conversion Application (Rule 1.11) <br />Permit # M -_ -_ (provide for Amendments and Conversions of existing permits} <br />DIVISION OF <br />MINERALS <br />GEOLOGY' <br />RECLAMATION <br />MINING•SAFETY <br />gill Owens <br />Governor <br />Greg E. Walther <br />Execwive Director <br />Michael 9. Long <br />Division Director <br />The application for a Construction Materials Regulaz l 12 Operation Reclamation Permit contains three major parts: (I) the application form; <br />(2) Extubits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure [o include one (1) wmplete si>med and notarized IVORY ORIGINAL and four (4) copies of the completed No <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnica] Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to <br />8 1/2" X 1 I" or 8 1/2" X 14" size. To expedite processing, please provide Ute information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. AppGcantlooerator or comoany name (name to be used on nermitl: <br />~`ha Fort Lvon Canal Company <br />1.1 Type of organization (corporation,partnersbip,etc.): Corporation (non-profit) <br />1.2 I.RS. Tax I.D. No. or Social Security Number: <br />2. Operation name(o k,tnineorskenamel: Fort Lyon - State Pit No. 1 <br /> <br />3. Permitted acreage (new or eafstin¢ slte): 4 4 . 5 permitted acres <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees <br />---- acres <br />4 4 . 5 acres <br />4.1 New Application $2.344.00 application fee <br />4.2 New Quarry Application $2 906.00 quarry application <br />4.4 Amendment Fee $1,938.00 amendment fee <br />4.5 Conversion tot 12 operation (set by statute) $2.344.00 wnversion fee <br />~. Primary commoditie(s) to be mined: limestone rock <br />5.1 Incidental wmmoditie(s) to be mined: 1. / lbs/Tons/vr 2. / lbs/I'ons/vr 3. / lbs/Tons/vr <br /> 4. / lbs/Tous/vr 5. / lbs/Toas/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: canal maintenance <br />5.3 Anticipated end use of incidental cotnmodi[ie(s) to be mined: n / a <br />