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v~- ~o~~-D7~ <br />STATE OF COLORADO <br />DIVISION Of RECLAMATION, MINING AND SAfEfY <br />Depadmlatt of Natural Resources <br />1313 Shuman St., Room 215 ~ ~- ; <br />~~ <br />••_ ~ <br />C O L O R A D O <br />Deem l.dorado 90203 . DIVISION OF <br />Phorc (303)1166.3567 ~i~ilj ~~ .l %i l~iij RECLAMATION <br />FAX: t303i E3z~8106 M 1 N 1 NG <br /> Division of declamati E <br /> on, <br />MininG and Safet SAF <br />TY <br /> y <br /> CONSTRUCTION MATERIALS <br />e;n o":ns <br />SPECtst. (ttl) OPERATLON c°""°°~ <br />Russell Gemye <br />RECLAMATION PE1tMIT APPLICATION FORM Eweculive Director <br />RawN W. CMany <br />Division Dinxtp <br />W Wral Rewwm Trusbp <br />The application fora Cominution Materials Special 111 Operation Reclamation Perrmt co>tmms four major pads: (1) the application form; <br />(2) ExMbits A-I„ Addadutn 1, and any seetiems of Exhibit 6.5 (GeotechoiwlSialrifity Exhibit), es regiircdlay tla:OH-uce, and oatlinedin <br />Rules 6.1, 6.2, 63, 6.5, sad 1.6.2(1 xb); (3) the application fee; (4) the Perfautance Warrantyand iftequired a Flinatteial Warrmriy. When <br />you submit your applipti0n, be sere to mchlde sae (1) toomletrd. stettd and>oolarved ORIGINAL and one (1) c~yof the wmpleted <br />application fortq two (2) oopas of Exhibits A-4 Adde>alum I, appropriate secti~s of Extn'bit 6S (Geoteclmical Stability Exbibit), as <br />required, a cixdt fortlte application fee descrbed order (A) below, aid We tullyexavtedPerfotmaoce Watraotyaod Financial Warrmtty, if <br />rCglmed. Exhibits should NO' 6e holmd ~ in 3-ring biodeES; maps should be Bolded to 8 2" X t 1" or 8 2" X t4• size. To expedite <br />processing, pkme provide the mfamation in the foment snd order descrbed in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print dearly, In the apace provided, all Information described below <br />1. Anotlcantlotrerator or cemnanv name (name to be used on the trermitl: <br />Flatiron Constructors Inc <br />1.1 Type of organization (corpotatioq parmership,ex.): COrAOrat1011 <br />2. Ocerattonnatne(nit.mineornitenartEeh: Camenish Borrow <br />3. Permitted aereaRe: ~.~_ Permitted Acres <br />4. New Annhieation: 781.00 Application Fee <br />5. Prlmarvcemmoditidsltobemiaed: Sand and Gravel <br />6. Name of owner to the surface of aReded land: Phi 1 C amen i 5h <br />7. Name of owner to the aubsarfaee rlahb of af[ected land: Phi 1 Camen i s h <br />8. ~~ of tdninn otrenthon• _~ Surface _ Underground ~ Io-siro <br />9. L2eathln inforaafios: The ~ of the area where Itae rmjarity of mining will occur: <br />COUNTY: Weld <br />PRINCIPAL MERIDIAN (ctaxk one): ~,._ 6W (CDlwado) 10th (New Mexico) Ute <br />SECTION (write nlmdx;r): S 1 5 <br />TOWNSHIP (write oumbce and check direction): T 2 X North South <br />RANGE (write number and check direction): R 6 8 Favt X Wort <br />QUARTER SECTION (check one): NE X NW SE SW <br />QUARTER/QUARTER SECTION (check one): X NE NW SE SW <br />GENERAL DESCRIPTION: (the number of miles arxl direction from the nearest rown and the approximate elevation): <br />Office of Office of <br />Mined land Reclamation Active std Inaztive Mines <br />