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-4- <br /> REGULAR OPERATION (lit RF';EIVED <br /> RECLAMATION PERMIT, <br /> APPLICATION FORM OCT 19 <br /> 19 <br /> 9 <br /> 4 <br /> CHECK ONE: X New Application (Rule 1.4.5) _ Amendment Application (Rule 1.10) <br /> Conversion Application (Rule 1.11) Divlolan of Minerals&Geology <br /> Permit 4 M (provide for amendments and conversions of existing <br /> . permits) <br /> -he application for a Regular Operation Reclamation Permit contains three major parts: (1) <br /> the application form; (2) Exhibits A-S and Geotechnical Stability Exhibit; and, (3) the <br /> application fee. When you submit your application, be sure to include one (1) signed and <br /> notarized original and four (4) copies of the application form, five (5) copies of Exhibits <br /> A-R and any required sections of Exhibit S and the Geotechnical Stability Exhibit, and a <br /> . check for the application fee described under Section (16) on Page 3. Exhibits should not <br /> be bound or in a 3-ring binder; maps should be folded to 8 1/2" X Ill or 8 1/2" X 14" size. <br /> To expedite processing, please provide the information in the format and order described in <br /> this form. <br /> GENERAL OPERATION INFORMATION <br /> • Type or print clearly, in the space provided, all information described below. <br /> 1 . Applicant/operator name: Cooley Gravel Comoanv <br /> 1.1 Type of organization (corporation, partnership 41FLt,)[ta Corporation, Licensed to do <br /> bu <br /> 1.2 I.R.S. Tax I.D. No. : 04-040340 <br /> _ . Operation name (pit, mine or site name) : Dahlia North Resources Pit <br /> 3 . Permitted acreage (new or existing site) 180.1 permitted acres <br /> 3 .1 Change in acreage (+ or -) aCIYS <br /> 3 .2 Total acreage in Permit area 180.1 acres <br /> • 4 . Fees: <br /> 4.1 New Application $1. 875 .00 application fee <br /> 4.2 New Quarry Application $2,325.00 quarry application <br /> 4.3 Milling Application (Non-DMO) $3,100.00 milling application <br /> 4.4 Amendment Fee $1,550 .00 amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) $1,500.00 conversion fee <br /> S . Primary commoditie(s) to be mined: sand and (Travel <br /> 6 . Name of owner of surface of affected land: r'nol" ( raVPl Company <br /> 7 . Name of owner of subsurface rights of affected land: Cooley. Gravel Company <br /> If 2 or more owners, refer to Exhibit O. <br /> • 8 . Type of mining operation: ) Surface _ Underground <br /> 9. Location Information: the center of the area where the majority of mining will occur <br /> lies in: <br /> COUNTY: Adams <br /> PRINCIPAL MERIDIAN (check one) : g 6th (Colorado) loth (New Mexico) _ Ute <br /> SECTION (write number) : S <br /> TOWNSHIP (write number and check direction) : T _ North South <br /> RANGE (write number and check direction) : R East West <br /> QUAP.TER SECTION (check one) : NE _ NW X SE _ SW <br /> QUARTER/QUARTER SECTION (check one) : -y- NE NW SE SW <br /> GENERAL DESCRIPTION (miles and direction from nearest town aad approximate elevation) : <br /> Property is within City of Commerce City. Only other town within 2 miles is the <br /> City of Thornton. Approximate elevation - 5070, <br /> ORIGINAL <br />