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iii nniiiiiiiii iii , <br />DIVISION OF MINERALS AND GEOLOGY <br />Depanmenl of Natural Resources <br />1313 Sherman SI.. Room 215 <br />Denier. Colorado 80203 <br />Phone: (3031 8663567 <br />FAX: 13031 832-8106 <br />• <br />STATE ~~CC <br />.. _„ ^n <br />nuu ~ :1 1yy6 <br />p,v161on or Minerals & Geology <br />CONSTROCTION MATERIALS <br />REGULAR OPERATZON (112) <br />ATION PERMIT APPLICATION FORM <br />~! <br />~I~~~ <br />DEPARTMENT' OF <br />NATURAL <br />RESOURCI=.S <br />Rov Romer <br />Governor <br />lames 5. Lochhead <br />E.ecviive Direcror <br />Michael B Long <br />Dnision Dnena <br />CHECK ONE: ~~ New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit ~ _- - -_ (provide for Amendments and Conversions of <br />existing permits) <br />The application for a Regular 112 Operation Reclamation Permit contains three major parts: (1) <br />the application form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnic+il <br />Stability Exhibit; and (3) the application fee. When you submit your application, be sure 7.0 <br />include one (1) complete sinned and notarized IVORY ORIGINAL and four (6) copies of the completed <br />ivory application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 <br />(Geotechnical Stability Exhibit, and a check for the application fee described under Section (~4) <br />below. Exhibits should not be bound or in a 3-ring binder; maps should be folded to 8 1/2" X 1:1" <br />or 8 1/2" X 14" size. To expedite processing, please provide the inform tion in the format and <br />order described in this form. ~ ~ "1 <br />__________________________________________________________________~=_ ~ ~=n~~L=====_______ <br />GENERAL OPERATION INFORMATION <br />Type or print clearly in the space provided the information requested below. <br />1. Applicant/operator or company name (name to be used on permit): <br />Hall-Irwin Construction Co. _ <br />1.1 Type of organization (corporation, partnership, etc.): COT]JOI'atlOn - <br />1.2 I.R.S. Tax Z.D. No. or Social Security Number: <br />2. Operation name (pit, mine or site name): Firestien Pit - <br />3. Permitted acreage (new or existing site) 133 permitted acres <br />3.1 Change in acreage (+ or -) - acres <br />3.2 Total acreage in Permit area 133 acres <br />4. Fees: <br />New Application 51,875.00 application free <br />.2 New Quarry Application 52,325.00 quarry application <br />4.3 Milling Application (Non-DHO) 53,100.00 milling application <br />4.4 Amendment Fee 51,550.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) 51,500.00 conversion fee <br />5. Primary commoditie(s) to be mined: Sand Gravel <br />5.1 Incidental commoditie(s) to be mined: 1. - lbs/Tons/vr <br />2. / lbs/Tons/vr 3. / lba/Tons/vr <br />4. / lbs/Tons/yr 5. / lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: COnStrUCtlOn (•)aterial5 _ <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: _ <br />