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G~€~~~8 STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources JAN 13 2005 <br />1313 Sherman 6t., Room zt s C O L O RAD O <br />Denver, Colorndo 80203 Division of ~lme~als and,~G¢4lo D[ V I S[ O N o f <br />Phone: f303) 866-3567 CONSTRDC'I7(!lV ~'r'RAiAI C ry~ ~~ ~~~~~ M I N ERA L S <br />FAX: 1303) 832-8106 REGIILAR (111) OPERATION 'p~'•ion ~) ; L:.r s C: Cealr G E O L O G Y <br />RECLAMA'PIONPERNIITAPPLICA'PIONFORM / ~FGtANATION•NINING <br />SAFETTKCIENCE <br />alit QvMS <br />CHECK ONE~"X There is a File Number Already Assi~ed to this Operation GOVtmOf <br />/pennit # 1~-2004 084 ._ RBI ~~ <br />(Please reference the fik number ~tiY assigned to this operation) exec uuve Director <br />X New Application (Buie 1.4.5) _ Amendment Application (Rule 1.10) aG"'ia w. Gamy <br />~- Division DileCGr <br />_ Cowerslon Appfication (Rule 1.11) Natural Resource TTUStee <br />Permit # _ fvL-= _ (provideforAmendmea/s and Conversions ~eadstmg Permits) <br />The application for a Construction Materials Regular 112 OperationReclamationPetmit coNains ihtce major parts: (1) the applicationfotat; <br />(2) Exlnbits A-S, Add~drmm 1, mry suctions of E~dubit 6.5 (Geatachnical Stability PxLtbit; and (3) the applicatianfee. GVhmyou sub®ityatr <br />application, be sure to include one (1) complete signed andnotarved ORIGINAL and one (1) copy of the completed appliE~tionform,two (2) <br />copies ofExMbits A-S, Addwdinm t, appmpriate sections of6.5 (Geoteohnical Stability Exhibit, and a checdc far the applicefionfee tlesmbed <br />under S~ction(4)below. Exlubitsshould>KDabebonedorina3-ringbintler;mapsshaildbefoldedto8 t2"X11"or81/2"X14"sine. To <br />cxpeditc P~B~ Please provide the information in the format and order described in this farm <br />GENERAL OPERATION INFORMATION <br />or print clearly, to the space provided, ILL hdormation requested below. <br />1. ApoDcrmtlocerator orcempanv Dame (name to be need on cermitl: Benson Brothers <br />1.1 Type of organization (oaporation, partuership, etc.): Partnership <br />I.2 I.R.S. Tait I.D. No. m Social Seatrity Number: <br />2. O~erationname(pit.mi~or4itensmel: Benson Brothers Pig Mesa Pit „/~ <br />3. Permitted acrea$g, (new or eiiadne aitel: <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />39 permitted aeaes <br />acres <br />39 acres <br />4. ~ <br />4.1 New Application $2344.00 application fee <br />4.2 New Quarry Application $2.906.00 quarry applicatiar <br />4.4 Amendment Fee $1938.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) $2344.00 conversion fee <br />5. Prim ary oommoditle(al to 6e mined: Sand Gravel <br />5.1 Incidental commoditie(s) to be mined: 1. - lbs/ToDSlvr 2. / Ib slfons/vr <br /> 3. / Ibsrl'ons/vr 4. / Ibs/fans/v_r 5, / Ib sffons/vr <br />5.2 Anticipedadenduseofptimarycbmmoditie(s)mbemitred: Constructionaggregate <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />Office of (lfiice of Colorado <br />