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~ • <br />STATE OF <br />^IVISION OF MINERALS AND GEOLOGY <br />Urparlinrnt .n N,t0.ir31 Resources <br />I {1 S Shrrm~ui St., hoom '_15 <br />Denver, Culurdda l4U'_U3 <br />Phnnc: I3U31 Bit6.15hi <br />rnx. I loll n s ~ n loh <br />CONSTRUCTION h1ATERlALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />firer; E. Walchc~ <br />Execw~s~e Dhcuw <br />CHECK ONE: X New A lication Rule 1.4.i Amendment A lication Rule I.10\" cnael s. toot; <br />PP ( ) pp ( plvlymn D'~reanr <br />_ C,,}o'yn~vyyer~~sion Application (Rule I.I I ) <br />Permit # Nt ~V.I,J~_ (provide for Amendments and Conversions ofexisting permiLS) <br />The application for a Construction Materials Regular 1 12 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibiu A-S, Addendum I, any sections ofExhibit 6,5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (I) complete sitmed and notarized IVORY ORIGINAL and four (4) copies of the completed Ivory <br />application fotm, five (i) copies of Exhibits A-S, Addendum 1, appropriate sectiotu 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 [o <br />8 112" X l l" or 8 112" X 14" size. To expedite processing, please provide the 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 requested below. <br />ApplicanUooeratororcomoan~name(nametobeusedonoermitl: J and K Limestone Products, LLC. <br />1.1 Type of organization (corporation, partnership, etc.): <br />1.2 I.R.S. Tar I.D. No. or Social Security Number: 5 7 1 _ 4 R _ 7 7 5 5 <br />2. OQerationname(nit.mineorsitename): J and K Limestone Products - Villa Grove Pit <br />3. Permitted acreaee (new or existine site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />COLS 1~~ <br />or~Do <br />REC <br />SEP 142000 <br />~~ <br />DIVISION OF <br />MINERALS <br />GEOLOGY <br />0. E C L P M A T I O N <br />MINING•SAFE7Y <br />Dlvlslon of Minerals ~ tie ~ I wens <br />Governor <br />? B . 6 5 permitted acres <br />acres <br />38.65 acres <br />4. Fees: q ? ? q q <br />4.1 New Application ,3~.,$26,,Ofd application fee <br />4.2 New Quarry Application 52.325.00 quarry application <br />4.3 Milling Application (Non-DMO) 33.100.00 milling application <br />4.4 Amendment Fee 3 L550.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) 3 (.875.00 conversion fee <br />5. Prim arycommoditie(5ltobemined: Gravel Sand Crush Rock <br />5.1 Incidental commoditie(s) to be mined: I. IbsJTonsJvr <br />3. i Ibs/ions/vr 4. / Ibs/fons/vr <br />~ / Ibs~I'ons/vr <br />5. / Ibs(Tons/vr <br />5? Anticipated end use of primary commoditie(s) to be mined: Ba ~ a r~rnr r se and Fitt ma + a r ; a t f p= <br />road construction <br />5.3 Anticipated end use oFincidental commoditie(s) to be mined: <br /> <br />