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<br />STATF. OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Depanmem of Natural Resources <br />I } I }Sherman SL. Room ? 15 <br />DIVISION O <br />Den.•er, Colorado BO?03 <br />Phone' 130}7 866J567 CONSTRUCTION MATERL4L5 M I N E RA L <br />FAY (3031 832-8106 REGULAR (112) OPERATION 6i <br />GEOLOG <br />RECLAMATION PERbITT APPLICATION FORt~t a E C ~ A M A T l 0; <br />MINING•SAEET <br />gill Owens <br />Gwemor <br />CI-IECK ONE: There is a File Number Already Assigned [o this Operation <br />Greg E. Walther <br />Permit # M -_ _ (Please reference the file number currently assigned to this operation) Exetwme oo-eaor <br />Michael 8. ~o~g <br />~_ New Application (Rule L4.5) _ Amendment Application (Rule 1.10) o~~~:.on oireuor <br />Conversion Application (Rule 1.11) <br />Permit # M - (provide for Amendments and Conversions of exutmg permit,) <br />The application for a COnShnChOn Materials Regulaz l 12 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhtbits A-S, Addendum 1, any sections of Exhibit 6.~ (Oeotechnical Stability Exhtbrt; and (3) the application fee. When you submit your <br />application- be sore [o include one (1) complete siffied and notarized IVORY ORIGINAL sad fpm (1) copies of the wmpleted Ivon~ <br />application form, &ve (5) copies of Exhibits A-S, Addendum 1, appropriate sectioas of 6.i (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 I/2" X I I" or 8 1/2" X 14" size. To expedite processing, please provide We information in the forma[ and order described in this form. <br />GENERAL OPERATTON INFORMATION <br />T}pe or print clearly, in the space provided, all information described below, <br />AooGcanUooerator or comoanv Dame (name to be used o0 oermk): <br />Rough Cut, LLC <br />1.1 Type of organization (corporation, partnership, etc.): LLC <br />1.2 I.RS. Tax I.D. No. or Social Sceurity Number: <br />2. Operation name (nit, mine or site Dame): Rough Cut Pit <br /> <br />3. Permitted acrease (new or existine sitel: 46 7 permitted acres <br />3. I Change in acreage (+) acres <br />31 Total acreage in Permit azea 46 7 acres <br />4. Fees: <br />d.l New Application $23ddA0 application fee <br />J.2 New Quarry .4ppbcation $2.906.00 quarry appbcatiou <br />~1.4 Amrndment Fee $1.938.00 amendment fee <br />45 Conversion to 112 operation (se[ by statute) $2344.00 conaenion fee <br />~. Primary commoditie(s) to be mined: Sand r:raval <br />i. I Incidental commoditie(s) to be mined: 1. Nnnd lbs~l'ons/vrlbs~l'ons/vr 2. / Ibs/I'ons/vr 3. / IbsiTonshT <br />4. / IbsRonshT 5. / lbs(foos/vr <br />i1 Anticipated end use of primary commoditie(s) to be mined: Construction Materials <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: NA <br />