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<br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80?03 <br />Phnnc: 13031 86G-3567 <br />FAk 130N 83?-BI Uh <br />• III IIIIIIIIIIIIIIII <br />999 <br />TE OF COLORADO <br />APR 18 2001 <br />Division of Minerals and Geology <br />VED <br />APR 0 6 2001 <br />Division of Minerals and Geology <br />CONSTRUCTION MA'r'FRTST•S <br />LII~ffTED Il~ACT (110) OPERATION <br />PERMIT APPLICATION FORM <br />~~~~ <br />DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />Ro. Romer <br />Governor <br />lames 5. Lochhead <br />Enecutive Dvecror <br />Michael B. Long <br />CHECK ONE: New Application. (F.u le 1.9) Conversion Ppplication (P.ule 1.11) Division D~recnr <br />Amendment Application (C.R.S. 39-32.5-110) <br />Permit # M - 2000-072 -_ (provide for Amendments and Conversions of <br />existing permits) <br />The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit <br />contains three major parts: (1) the application form; (2) Exhibits A-J, Exhibit L, Addendum 1, <br />any sections of Exhibit 6.5 'and Geotechnical Stability Exhibit, as required by the Office, and <br />outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(6); and (3) the application fee. When you <br />submit your application, be sure to include one (1) complete sinned and notarized IVORY ORIGINAL <br />and one (1) copy of the completed Ivory application form, two (2) copies of Exhibits A-J, <br />Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as <br />required, and a check for the application fee described under (9) below. Exhibits should NOT be <br />bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" or 8 1/2" X 14" size. To <br />expedite processing, please provide the information in the format and order described in this <br />form. <br />- - --------------------------------------------------------- <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, is the space provided, ALL information described below. <br />--------------------------------------------------------------------------------------- <br />1. A licant/operator or comaanv name (name to be used on toermit): <br />B & D Trucking <br />1.1 Tvoe of organization (corporation, partnership. etc.) : Partnership <br />1.2 I.R.S. Tax ID No. or Social Security Number: <br />2. Operation name (pit• mine or site name): A & D Truckin <br />3. Permitted aereaae (pea or existing site): 9•`}-- permitted acres <br />3.1 Change in acreage (+) _ _ acres <br /> Total Acreage in Permit Area 9.5 acres <br /> <br />9. Fees• <br />4.1 New Application 5875.00 application fee <br /> Amendment Fee (C.R.S. 34-32.5-125(II)) 5575.00 application fee <br />9.2 Conversion Fee (from 110d to 110 5875.00 conversion fee (Rule 1.11.2(2)) <br />5. Pr+T=* y commoditie(s) to be mined: tOp 6011 <br />5.1 Incidental commoditie(s) to be mined: 1. lbs/Tons/vr <br /> 2. / 165/Tons/vr 3. / 1bs/Tons/vr <br /> 9. / lbs/Tons/vr 5. / 1bs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: lawns & Gardens <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />