PERMFILE121378

• Permit No: M2000059
• IBM Index Class Name: Permit File
• Doc Date: 6/5/2000
• Doc Name: NOTICE
• Media Type: D
• Archive: No

: •
RECEIVE
DIVISION OF MINERALS AND GEOL~~ 1 O ZOOO
Department of Natural Resources
7 313 Sherman 51., Room ? 15 L7iVISion of Minerals 8 Geology
Denver, Colorado 80203
Phone: [phone]
FAX: U03) 832-8106
CONSTRIICTION MATSAIALS
COLOiv'~DO
~/ ~~~~/
G,yo Ji~~
f~~~s~
LIMITED IMPACT (110) OPRRATION
~~
~~
DEPARTMENT OF
NATURAL
RESOURCES
Roy Romer
Governor
RECLAMATION PERMIT APPLICATION FORM lames 5. Lochhead
E.ecwive Drteaor
Michael B. Lang
Division D~recmr
CHECK ONE: !/New Application (Rule 1.4) Ameadment Application (C.R.S. 34-32.5-110)
Conversion Application (Rule 1.11)
Permit # - -_ (provide foz Ameadmenta and Conversioas of
existing permits) ~ -7rM~ _~
The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit
contains three major parts: (1) the application form; (2) Exhibits A-J, Exhibit L, Addendum 1,
any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the Office, and
outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When you
submit your application, be sure to include one (1) complete'signed and notarized IVORY ORIGINAL
and one (1) copy of the completed Ivorv application form, two (2) copies of Exhibits A-J,
Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as
required, and a check for the application fee described under (4) below. Exhibits should NOT be
bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" or 8 1/2" X 14" size. To
expedite processing, please provide the information in the format and order described in this
form.
-----------------------------------------------------------------------------------------
GENERAL OPERATION INFORMATION
Type or print clearly, in the space Drovided, ALL informatioa described below.
-------- -----------
--------------------------------------- ----------------------------------------
1. ADDlicant/operator or company name (aame_to be_used on permit):
1.1 Type of organization (corporation, partnership, etc-):
1.2 I.R.S. Tax ID No. or Social Security Number:
2. ODeratioa aame (pit, mice or site name) : CC.PY(7l(, l7/(([[EF V
'3. Permitted acreage (aew or existing site):
3.1 Change in acreage (+ or -)
Total Acreage in Permit Area
4. Fees:
r/,~ permitted acres
acres
acres
4 .1 New Application 5875.00 application fee
Amendment Fee (C.R.S . 34-32.5-125(II)) 5575.00 application fee
4 .2 Conversion Fee (from 10 878 5.00 conversion fee (Rule 1.11.2(2))
110d to 1
5. Primar y commoditie(s) to be (
miaed: ~,/~ ,e~.nd ~~~SG(V
5. 1 Incidental commoditi e(s) to be mined: 1. lbs/Tons/yr
2. / lbs/Tons/yr 3. / lbs/Tons/yr
4. / lbs/Tons/yr 5. / lbs/Tons/yr

5.
2
Anticipated end use
of primary commoditie(s) to /
be mined: ~u/7//a7i02ir~Yl~iad1.Y/.(Q~
5. 3 Anticipated end use of incidental commoditie(s) to be mined:
STATE OF