PERMFILE131001

• Permit No: M2001035
• IBM Index Class Name: Permit File
• Doc Date: 3/29/2001
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY v.KJC
Depanmern of Natural Resources ll((JJ
I} 13 Sherman SL, Roam 21 i D I v 15 1 0 N O s
Denver, Colorado 00203 /~
Phone~1303)866~3567 CONSTRUCTION MATERIALS Fs,,,~~Vc MIN &RA LS
fAX. [phone] REGULAR (112) OPERATION MMdd CQ
RECLAMATION PERMTT APPLICATION FORM'R 2~ G E O L O G 1'
~`~:}~ R E C L A M A T I O N
J MINING•SAFETY
~i~ision of
MineratsaodCep( BillOwens
aB1' Governor
CHECK ONE: There is a File Number Already Assigned to this Operation
Gr¢g E. Walther
Petmit # M -_-_ _ (Please reference the file number cttmntly assigned to this operation) Executive Dv¢aor
nlichael a. Long
New Appbcauon (Rule 1.4.5) _ Amendment Application (Rule I.10) Dwi:.on Dir¢<lor
_ Conversion Application (Rule I.11)
Permit # M -_ (provide for Amendments and Conversions of existing permits)
The application for a Conswction Materials Regulaz 112 Operation Reclamation Permit contains diee major parts: (1) the application form;
(2) Exhibits A-S, Addendum 1, any secuans of Exhibit 6.5 (GeotecFmical Stability Exhibit; and (3) the appbcation fee. When you submit your
application, be sure to include one (1) comolete si®ed end notarized IVORY ORIGINAL and four (4) copies of [he completed Ivy
application form, Sve (5) espies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechuical 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 1/2" X 1 I" or 8 1/2" X 14" size. To expedite processing, please provide Ute utfotmation in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, all informatioe described below,
I. Aaoticaot/ooerator or comoanvname (name to be used on oermk):
ACQ 1~2nr~ii~rs i.l/~ //~J
1.1 Type of organisation (corporation, partnership, etc.): ( nznn,2.4 rvrn
1.2 ].R.S. Tax LD. No. or Social Securirv Number: g~ - /4754.35 ~
2. Ooeratioo name (nit, mine or site Dame): /.tour ~'QeF~I /~. r
~~' o
3. Permitted acreatte (new or existing site): ~~ ~~ pertrutted acres
3.1 Change in acreage (+) \/ ~~~/_' ~,~ acres ~~+^'-
3.2 Total acres a in Permit area saes y"~~
4. Fees: ~`~\ ,I~',pxK~S`g" 5`
~ rJ, fa_
4. I New Application $2.344.00 application fee ~
4.2 New Quarry Application $2,906.00 quarry application
4 4 Amendment Fee $1,938.00 amendment fee
45 Conversion to 112 operation (set by statute) $2.344.00 conversion fee
5. Primary commoditie(s) to be mined: F./t c5aun R,P]QAA
5.1 Incidental commoditie(s) to be mined: 1. / Ibs/fons/vr 2. / Ibs/Coos/vr 3. / Ibs/l'ons/vr
4. / lbsll oas/vr 5. / Ibs/Ionshr
5.2 Anticipated end use of primary commoditie(s) to be mined: ( .s~-r s rau ~ sii.n~g n= p ivLc
5.3 Anticipated end use of incidental wmmaditie(s) to be mined: ~.-„-, ss,our-i~„',~,v, /,9 ~