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STATE OF COLORA~=J _ <br />DIVISION Of MINERALS AND GEOLOGY <br />Department of Natural Resources ~ ~ _ ~~'°"4.' <br />1313 Sherman 5t., Room 21> ~~ ~i <br />Denver, Colorado 80203 ~ r,~t^~i DIVISION o <br />Phone: (3031866-3567 CONSTRUCTION MATERIALS / / ~~~ Q r-tr. { MIN & R A..L S <br />FAX: (303) 832-8106 REGULAR (112) OPERATION V <br />RECLAMATION PERMIT APPLICATION FO stop of Minerals and Gaalo(I G E O L O G Y <br />RECLAMATION <br />MINING•SAF ETY <br />Bill Owens <br />Eovernor <br />CHECK ONE: ~ There is a File Num/ber Already Assigned to this Operation <br />Permit # M -~- Z 7 5 `~ (Please reference ttte file number current}y assigned to this operation) <br />New Application (Rule 1.4.5) <br />Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M -_ (provide for Amendments and Conversions of existing permits) <br />Greg E. W archer <br />Executive Director <br />Michael 6. LOng <br />Division Direcor <br />The application for a Construction Materials Regulaz 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Ex}ubit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete sired and notarized IVORY ORIGINAL and four (4) copies of the completed Ivory <br />appbcation form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotecbnical 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 1/2" 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 />1. Aoalicaot/ooerator or comoanv name (name to he used on uermitl: <br />Diana K. Watson <br />1.1 Type of organization (corporation, partnership, etc.): i n d i y i d u a l <br />1.2 I.RS. Tax I.D. No. or Social Security Nttmber: <br />2. Operation name (nit, mine or site Hamel: Stout-A®Cd k P i t <br />3. Permitted acrease (new or eaistine sitel: 42 - 8 permitted acres <br />3.1 Change in acreage (+) acres <br />3.2 Total acreage in Permit azea 42 • 9 acres <br />4. Fees <br />4.1 New Application $2.344.00- application fee <br />4.2 New Quarry Application $2.906.00 quarry application <br />4.4 Amendment Fee $1.938.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) ~ $2344.00 conversion fee <br />~. Primarvcommoditie(s)tobemined: GRAVEL. SAND <br />5.1 Incidental commoditie(s) to be mined: 1. // Ibs/foas/yr 2. / Ibs/Tons/vr 3. / lbs/Tons/vr <br /> 4. / Ibs/Tons/~r 5. / Ibs/Tonslvr <br />5.2 Anticipated end use of primary wmmoditie(s) to be mined: General c o n s t r u c t i o n <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />