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<br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />131 7 Sherman St., Room 215 <br />Denver, CoVorado 90203 <br />-r_ AT_~ <br />999 <br />~- 2,00-022 <br />OF COLORADO <br />Phone: (303) 966-3567 CONSTRUCTION MATERIALS <br />fAX: 1303) 932-8106 REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: There is a File Number Already Assigned to this Operatioe <br />Permit # M -_-_ _ (Please reference the fde number currently assigned to this operation) <br />,~_ New Application (Rule 1.4.5) <br />Amendment Application (Rule 1.10) <br />Coovenioo Application (Rule 1.11) <br />Permit # M - /1~J1 -~-_ (provide for Amendments and Coovenrons of existing permits) <br />~~ <br />DIVISION OF <br />MINERAL <br />GEOLOGI <br />RECLAM ATIOn <br />MINING•SAFETY <br />Bill Owens <br />Governor <br />Geg f. Watcher <br />Execwne D"enor <br />Michael B. Long <br />Division Director <br />The applicatiou for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) Ute appbcaion form; <br />(2) Exhibits A-S, Addrndum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhlbir and (3) the application fee. When you submit your <br />applicaioq be sure to include one (1) complete si®ed and notarized IVORY ORIGINAL and four (4) copies of the completed Ivon <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geo[echnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-rmg binder, maps should be folded to <br />8 12" X 11" or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />ApalicrmUoceraior or rnmpany pame (name to be used on pelaritl: <br />t.ovel and Ready ldix Concrete, Inc. <br />1.1 Type of organization(corporaiogparmerslip,etc.): Corporation <br />1.2 I.RS. Tax I.D. No. or Social Security Number: <br />2. Operation ~amelpit. mine or site Hamel: <br />3. Permitted acreage (new or existing sfte): <br />3.1 Change in acreage (+) <br />32 Total acreage in Permit area <br />Creen/Croissant Property Sand and Gravel Mine <br />4. Fees: <br />4.l New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary rnmmoditie(sl to be mined: <br />210 permitted acres <br />BCICS <br />210 <br />acres <br />52.344.00 application fee <br />52.906.00 quarry application <br />51.938.00 amendment fee <br />S2 344.00 conversion fee <br />5.1 Incidental commoditie(s) to be mined: 1. / Ibs(foos/Yr 2. / lbs/toas/vr 3. / Ibs(Tops/vr <br />4. 1 lbslfons/vr S. / lbs/I'ons/vr <br />5.2 P.n[icipated end use of primary commoditie(s) to be mined: <br />5.3 Anticipated end Ilse of incidental commoditie(s) to be mined: <br />