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Q~#"6~3~ <br />• ~~ X33-77 <br />STATE OF ~OLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Departmen[ o! Na[ural Resources nn <br />F I!1 E ~ <br />1313 Sherman St.. Room 215 F ~ <br />r1 ~- <br />Denver. Colorado 80203 <br />Phone: (303) 866-3567 Stl' 0 41997 <br />FAX: (303)832-8106 <br />mxsxxvcriox elATERIAI.Slivision of rranerals x geology <br />RBGULAR OPBRATIOx (112) <br />~\~ a~ ~ RECLAxATION PERILIT APPLICATION FORK <br />d a~ <br />~I~ <br />DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />Rq Romer <br />Gwemor <br />lames S- Lochhead <br />Execunve Director <br />MiclvN 8. Long <br />Division Director <br />:AECR ONE: 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 <br />existing permits) <br />fhe application for a Regular 112 Operation Reclamation Permit contains three major parts: (1) <br />.he application form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical <br />;tability Exhibit; and (3) the application fee. When you submit your application, be sure to <br />include one (1) complete sicmed and notarized IVORY ORIGINAL and four (4) copies of the completed <br />ivory application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 <br />(Geotechnical Stability Exhibit, and a check for the application fee described under Section (4) <br />celow. Exhibits should not be bound or in a 3-ring binder; maps should be folded to 8 1/2" % 11" <br />~r 8 1/2" X 14" size. To expedite processing, please provide the information in the format and <br />order described in this form. m_~~-Q <br />GENERAL OPERATION INFORMATION <br />Type or print clearly in the space provided the information requested below. <br />Applicant/operator or company name (name to be used on permit): <br />1.1 Type of organization (corporation, partnership, etc.): COUntY Government <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: <br />operation name (pit, mine or site name): EyP_rhr3rt Pit <br />Permitted acreaee (new or existing site) 7R(1 permitted acres <br />3.1 Change in acreage (+ or -) N/A acres <br />3.2 Total acreage in Permit area 280 acres <br />Fees• <br />9.1 New Application 51.875,00 application fee <br />4.2 New Quarry Application 52,325.00 quarry application <br />4.3 Millinq Application (Non-DMO) 53,200.00 milling application <br />4.4 Amendment Fee 51,550.00 amendment fee <br />4.5 Conversion to 122 operation (set by statute) 51.875.00 conversion fee <br />Primary commoditie(s) to be mined: Gravel <br />5.1 Incidental commoditie{s) to be mined: 1. None - lbs/Tons/vr <br />2. / lbs/Tons/vr 3. / lbs/Tons/vr <br />4. / lbs/Tons/vr 5. / lbs/Tons/vr <br />5.2 ~ Anticipated end use of primary commoditie(s) to be mined: ROat1 maintenance <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: N/A <br />