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DlYt510N Of MiNERALS'AND GEOLOGY III 111111111111111 OF COLORADO <br /> Department of Natural Resources 999 <br /> 1313 Sherman St..Room 215 <br /> p I v 15 1 ON o r <br /> Denver.Colorado 80203 <br /> Phone:(303)866-3567 M IN E RA L S <br /> FAX:(303)832-0106 RECEl V,Ep GEOLOGY <br /> RE C I AM AT I ON <br /> $Ep �8100� MINING•SAEETY <br /> CONSTRUCTION MATERIALS pivisi env Ovvens <br /> emo, <br /> REGULAR(112)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM o(Minerals and Geology ecoeg E owalcher <br /> E.ecume Director <br /> Michael e.long <br /> Division Directs <br /> CHECK ONE: _X New Application(Rule 1.4.5) —Amendment Application(Rule I.10) <br /> _Conversion Application(Rule 1.11) <br /> Permit# M -` f 1�3 -_ (provide for Amendments and Conversions of existing permits) <br /> The application for a Construction Materials Regular 112 Operation Reclamition Permit contains three major parts:(1)the application form: <br /> (2)Exhibits A-S,Addendum 1,any sections of Exhibit 6.5(Geotochnical Stability Exhibit;and(3)the application fee. When you submit your <br /> application,be sure to include one(1) complete signed and notarized IVORY ORIGINAL and four(4)copies of the completed Lvoty <br /> application form,five(5)copies of Exhibits A-S,Addendum 1,appropriate sections of 6.5(t reWechnical 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 I/2"X 1 V or 8 1/2"X 14"size. To expedite processing,please provide the information in the format and or"a described in this form. <br /> I <br /> GENERAL N INFORMATION <br /> Type or print clearly,In the space provided,all Information described below. <br /> 1. App6cant/operator or companv name(usme to be used ou permit): Roaring Fork ReBourcet3 <br /> 1.1 Type of organization(corporation,partnership,etc.): Corporation <br /> 1.2 I.R.S.Tax I.D.No.or Social Security Numbs. 84-1163944 <br /> 2. Operation name(pit.mine or site usme): Mamm Creek Sand & Gravel Pit <br /> 3. Permitted acreage(new or existing site): 308.36 permitted acres <br /> 3.1 Change in acreage(+) acres <br /> 3.2 Total acreage in Permit area 308.36 acres <br /> 4. ems: <br /> 4.1 New Application S2.344.00 application fee <br /> 4.2 New Quarry Application S2.906.00 quatry application <br /> 4.4 Amendment Fee S1.938.00 amendment fee <br /> 4.5 Conversion to 112 operation(set by statute) S2.344.00 conversion fee <br /> 5. Primary commoditle(s)to be mined: Sand Gravel <br /> 5.1 Incidental commoditie(s)to be mined: 1. NIA/ Ibs/foashT 2. / Ibs/fops/vr 3. / lbs(fonsiNi <br /> 4. / Iba/fons/vr 5. ! Ibs/fons/vr <br /> 5.2 Anticipated cad we of primary commodide(s)to be mined: Construction <br /> 5.3 Anticipated end use of incidental commodhie(s)to be mined: NSA <br />