PERMFILE126519

• Permit No: M2001001
• IBM Index Class Name: Permit File
• Doc Date: 3/21/2001
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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