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/~-ao~oy-o~7 <br />CONSTRUCTION MATERIALS <br />R£CULAR (l72) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE V There Is a Ffle Number Already waalgned m tots Operatloa <br />REG~i~ ;_ <br />,/ OCT 2 E 2004 <br />Division of T7iuct,.. ' <br />Permn H,_,T~,-_ ~_ _ (Please rpferctrce the file number currently easgoed to this operation) <br />_~ New Apphcadon (Rule 1 4 5) _ Amendment Applicatgn (Rule 1.10) <br />~_ Comeralon Application (Role 1 11) <br />Pcmut>! ~•_ _ _ (provide for Amendmenn and Conversions of exrsdng permiu) <br />The apphwtton for a Cons¢ucnon Matrnals Regulaz 112 Operation Reclamation Permn contains three maJOr pads (!)the apphcation <br />farm,(2)Exhrbns A-S, Addendum 1, any sections of Exhtbn 6.T(Geotrehntcal Stability Exlnbit, and (3)the apphcatgn fee. When you <br />suborn your application, be sum to include one (1) camglete si~cd end nom[iud ORIGINAL and one (]) copy of the completed <br />epphrahon form, two (2) copies of Exhrbtts AS, Addendum I, approprtam sections of GT (Oeotechnical Stability Exhibit, and a check for <br />the applkanon fec dcarnbcd under Searon (4) below Exhrbio should LIQ'[ tw bound or in a 3•nng border, maps shouts be folded to <br />8 l!2" X l l" or 8 l2" X l4" nu. To expedik praessmg, pleau provuie the mfonnanon to the [rainiest and onkr desrnbed m tide form <br />GENERAL OPERATION INFORMATIDN <br />Type or print clearly, la the space provided, ~ Itifottnatlon requested below. <br />I Ao IlcanUone[a r or comoanv name freme to be toed pn oerrnlFl; Clear Creek District Water PrDVlders. LLC "~ <br />1 I Type of organization (corporation, parmcrship, ekJ; Limited Liability Corporation <br />1 2 1 R.S Tax t D No or Social Security Number 2t1_1 dt>QRgq <br />2. OogLaNon name Coit m1n44r afte name): MMRR (7uafry <br />J Permitted acreaee lnew or exbNne at1N 526.70 permitted saes <br />3 I Chango m acreage (+) acres <br />3 2 Total acreage m Permn area F2R.70 acres <br />4 e~F3. <br />4 I New Applicenon ,~fj,]44 00 application ire <br />~2 Ncw Quarry Application T2.906.00 9uanY appliatnon <br />44 AmeMment Fee T1.938.00 amendment fec <br />4 5 Cowerston to 112 operation (sct try statuk) ~f2.344 00 conversion Cm <br />5 Primarvmmmoaltteral to be mined: S_ peeification Construction Aggregates <br />5 1 Inndental commtxiine(s) to be mined: I NlA - Ibs/fonsror 2 / Ibs2onslvr <br />3 / Ibs?ona/vr 4 / IbsrTonsFn 5. ! Ibs/1'ons/vr <br />5.2 Anticipated and use of pnmery commoditie(s) to be mined: CDrIStrUCtlOn AQgregatOS (aH tVDBS) <br />5 3 Anhctpattd cnd use of tnadental wmmoditie(s) to be mined. N/A <br />Exhibit A <br />0001 <br />