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<br />~I~ II~'I~ill~~~~ II~ • <br />ST <br />OF COLORADO <br />DIVISION OF MINERALS ANO GEOLOGY <br />Departmrm of Nanual Resources <br />I SI S Sherman 5... R„om ~,, RECEIVED <br />Denver, Gulurado HU?U} <br />Phune:llll}1 iS66.}567 <br />FAX: LIO SI H}2-H1U6 A~~ ~ ~ 2000 <br />hl <br /> <br /> ~tvtsion of Minerals and Ge <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: X New Application (Rule 1.4.5) <br />_ Conversion Application (Rule 1. L 1) <br />~~ <br />DIVISION O F <br />MINERALS <br />GEOLOGY' <br />RECLAMATION <br />MI NING•$A FETY <br />ell ovens <br />Gnvemor <br />Greg E. Watcher <br />E.ecmne Director <br />_ Amendment Application (Rule I.I O~jr;chael a. Long <br />Sion D~reclor <br />Permit # M ;~-1.L1L-_ (provide for Amendments and Conversions of existing permits) <br />l__J <br />The application for a Conswction Mazerials Regular 112 Operation Reclamation Permit contains three major parts: (I) the application form; <br />(2) Exhibits A-S, Addendum I, arty sections ofExhibit 6.5 (Geo[echnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete si7~ned and notarized IVORY ORIGINAL and four (4) copies of the completed Iv~rv <br />application form, five (5) copies of Exhibits A-S, Addendum I, appropriaze sections of 6.5 (Geotechnical 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!Z" X I l" or 8 1/2" X 14" size. To expedite processing, please provide the informarion in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />AooGcaot/operator orcomoanvname(nametobeusedoooermity:Mario Bassi and Josephine Bassi <br />1.1 Type oforganvation (corporation, partnership, etc.): ; rnnr; arnrc <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: Sv~_~R~_nsu~ <br /> <br />2. Opentioo name (pit. mine or site name): Nnrrt, Farm Road ravel Pit <br />240.00 ermined acres <br />3. Permitted acresee (new or existine site): p <br />3.1 Change in acreage (+) acres <br />3.2 Total acreage in Permit area 240.00 acres <br />4. Fees <br />4.1 New Applicaton $2 , 344.00 YV.S7"Y.Ob application fee <br />4.2 New Quarry Application 52.325.00 quarry application <br />4.3 Milling Application (Non-DMO) 53.100.00 milling applicarion <br />4.4 Amendment Fee 51.550.00 amendment fee <br />4.5 Conversion to l l2 operation (set by statute) 51.875.00 conversion fee <br />5. Primary commoditie(s) to be mined; Gann g avel F; 11 Afa rial <br />5.1 Incidental commoditie(s) to be mined: I. ~[/A - Ibs/Tons/vr <br />3. / Ibs/fons/vr 4. ! lbsffonslvr <br />2. / Ibslfons/vr <br />5. 1 Ibs/Tonslvr <br />5.2 Anticipated end use of primary commoditie(s)tobemined: ('nncrr„r r; nn Aggrega s rnncrete. asphalt. <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: ni / n road base <br />