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~~° -~ • IIIIIIIIIIIIIIIIIII ~ -~'-. <br />OF~L'~RADO <br />DIVISION OF MINERALS AND GEOLOGY I t/~r 3 0 1991 <br />Depanment of Natural Resources <br />7 37 3 Sherman St., Room 215 I`d~~~~ <br />Denver, Colorado 50203 II <br />Phone: (303) 8663567 JIV161Li ~ -.......",-." .. wp0 OQy <br />FA%. (303) 832-8106 <br />CONSTRQCTIOR IWTSRiar.c DEPARTMF.NI' OF <br />NATURAL <br />LIlLITED I!0?ACT OPERATION (110> RESOURCES <br />ggciavsTION' PERMIT APPLICATION FORM RoY Rnn¢r i <br />Goverrnr <br />Wines 5. Lochhead <br />&ecuti~e Director <br />Miduel B. long <br />Division Director <br />CF~CR oNE: ~_ Heut Application (Rule 1.4) '-e,nct".e..t Application (C. R. S. 34-32.5-110) <br />Conversion Application (Rule 1.11) <br />Permit # {provide for Amendments and Conversions of <br />existing permits) <br />The application for a Construction Materials Limited Impact ?fining (110) Operation Reclamation <br />Permit contains three major parts: (1) the application form; (2) Exhibits A-J and Exhibit L, <br />Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the <br />Office, and outlined in Rules 6.1, 6.2, 6.3, and 6.5; and (3) the application fee. When you <br />submit your application, be sure to include one (1) complete signed and notarized IVORY ORIGINAL <br />and one (1) copy of the completed ivory application form, two (2) copies of Exhibits A-J and <br />Exhibit L, appropriate sections of 6.5 (Geotechpical Stability Exhibit), as required, and a check <br />for the application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring <br />binder; maps should be folded to 8 1/2" S 11" or 8 1/2" % 14" size. To expedite processing, <br />please provide the information in the format and order described in this form. <br />_--^--------_-- GENERAL OPERATION INFORMATION--- ~- y 7 - O 3 ~ ~~- <br />Type or print clearly, in the space provided, all information described below. <br />--------------------------- ---------------------------------- <br />1. A licant o rotor orMCO n name name to be used on rmit <br />1.1 Type of organization (corporation, partnership, etc.): <br />1.2 I.R.S. Tax ID No. or Social Security Number: ~~ <br />2. operation name (pit, mine or site name): ~A//LZ./A/1JS~ILL/ND/S CTRAU~t ~J7 <br />3. Permitted acreaoe (new or existing site): gj 7 7 permitted acres <br />3.1 Change in acreage (+ or -) acres <br />Total Acreage in Permit Area . 9 9 acres <br />4. Fees• <br />4.1 New Application 5875.00 application fee <br />Amendment Fee (C.R.S. 34-32.5-125(II)) 5575.00 ~ application fee <br />4.2 Conversion Fee (from ilOd to 110 875 5.00 conversion fee (Rule 1.11.2(2)) <br />5. Primary co®noditie(sl to be mined: ~j•' auEL- u~.4/V•17 <br />5.1 Incidental commoditie(s) to be mined: 1. - lbs/Tons/vr <br />2. / lbs/Tons/yr 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: ~~ L Ri(JU ~/LL S <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: ii//A <br />