Laserfiche WebLink
y • III IIIIIIIIIIIII III <br />• <br />s^r~TE or <br />~or~Do <br />DIVISION OF MINERALS AND GEOLOGY `rV@d <br />Department of Natural Resources y <br />t 313 Sherman St., Room 216 MqR 21~f <br />Denver, Colorado 80203 `V~~ <br />Phone: (3031866-3567 CONSTRUCTION MATERIALS <br />FAX: (3031 832-81 06 REGULAR (112) OPERATION D'V/8qn pf"~D F/~,f~ <br />RECLAMATION PERMIT APPLICATION FORM M'"ard/y $ Gepe <br />o~A °~ <br />CHECK ONE: _~_ There is a File Number Alresdy Assigned to this Operation OF~ C~ <br />Permit # M -~-~-_ (Please reference the file number currently assigned to this operation) <br />_ New Application (Rule 1.4.5) . .. ~ Amendment Application (Rule 1.46) B <br />_ Conversion Application (Rule I.11) <br />Permit # ~- Dl - ~~ 1 -_ (provide for Amendments and Conversions of existing permits) <br />~~ <br />DIVISION o <br />M[NEItAC: <br />GEOLOGI <br />0. ECLAMATIOn <br />MININ G•SAFETY <br />Bill Owens <br />Governor <br />Greg E. Walther <br />Executive Dlreaor <br />Michael B. Long <br />Division Director <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (I) the application form; <br />(2) Exhtbits A-S, Addendum 1, any sections of Exhibit 63 (Geotechnical Stability Exhrbit; and (3) the application fee. When you submit your <br />applicatio0. be sate to include one (1) complete sued and notarized IVORY ORIGINAL and four (4) copies of the completed Ivy <br />application form, live (S) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder. maps should be folded to <br />8 l f2" X 11" or 8 1 J2" X ] d" sizc. To expedite processing, please provide the information m the format and order described in this form: <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the apace provided, aU information described below. <br />1. <br />1.1 Type of organization (corporation,pattnetship,etc.): ~--1mL~ ~..ialJllµ~ `~ptYd'i[3trtt~ <br />1.2 I.RS. Tax I.D. No. or Socia] Security Number: g 4 " IrJ 4-l 1 rJ 5 <br />2. Overation name (pit, mine or site name): LINE CAMP ~l-}' <br />3. Permitted acea¢e (new or e:istine site): 8, 9 permitted acres <br />3.l Change in acreage (+) c3. ~ acres <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendmevt Fee <br />4.S Conversion to 1 l2 operation (set by statute) <br />~( ~_ acres <br />$2.344.00 application fee <br />$2.906.00 quarry application <br />$1.938.00 amendment fee <br />$2.344.00 conversion fee <br />Primary commoditie(s) to be mined: Sat tC1 a1'1~ Q d~i2,1 <br />S.1 Incidental commoditie(s) to be mined: 1. / Ibs/fovs/vr 2. ( Ibs(I'ons(vr 3. / Ibs/Ions~/ rr <br />4. ! ]bsffons/vr 5. / ]bsffons/vr <br />S.2 Anticipated end rue of primary cotttmoditie(s) to be mined: ~n`-~~UG~Y) c~.(~C{Y'2.C~2r~2. <br />5.3 Anticipated end rue of incidental commoditie(s) to be tamed: <br />