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STATE <br />DIVLSION OF MINERMS AND GEOLOGY <br />peparonent d Natural Resouces <br />t31351sem,an %., Roan its <br />Denver, Cobrado 80203 <br />Phone: 13 031 8 6 63 5117 <br />FA%: (303) 832$106 <br />RECEBl1E® <br />JAN 2 4 2006 <br />Division of Minerals and Gtology <br />CONSTRUCTION MATERLAIS <br />LIMITED II1iPAGT (IIO) OPERATTON <br />RECt.AMATION PERMEI' APPLICATION FORM <br />MINF~RALS <br />GEOLOGY <br />sw•ETY•SOENCE <br />eat (JN.N <br />GoEKr„or <br />a,snEll fwnge <br />Exevanlve t%reua <br />Ra,ntd w, Goan <br />CFIECK ONF, No There a a Pik Number Already Assigned to thLs Operation pivbiat Dtreaa <br />Natural Resos„ee Trustee <br />Permit # M -aD C D -_ (Please rcfereftce We fik mtmber currently assigned to Otis operation) <br />/ New Application (Ruk 1.4.5) Amendtaeot Application (RWe I.IU) <br />Coorenbn Application (Rtile 1.1 I ) <br />Pettttil # _~-_ ~ _ (provide far Amrntlmmp mtd Convertuona of existing pcmtiLc) <br />The application i'or a Conslrtrction Materials Limited Impact (1 l0) Opcraton Reclamation FEninit contains thrx major pans: (I) the <br />application form; (2) Exhibits A-), Exhibit L, Addcttdwtt 1, ntsy sationsof Exhibit 6.5 atd Gedechnical Smbi6ty E>;hibit, av toquitedby Ute <br />Ofhcc, and outlined in Rulee 6.1, 6.2, 6.3, 6.5, and 1.6.2{ I xb); mtd (3) the application fee. What )rou submityua application, be st>rc to <br />includa one ()) complete siEmed and nMatizod ORIGDdAL and o>k (1) copy oftlte completed application form, two (2) copiesofExhibits <br />A-), Exhibit L, Addendtan 1, and appropriate satiate of 6.5 ((IeOtahnitstl Stability Exhibit}, as regttved, and a check for the application <br />fce desmrbed under (4) below. Exltibits shtwld 1YOT be bound a in a 3-ring binder; maps should be folded to>;1/2' X l l' org 12" X ]4" <br />sire. To ewpedite pnxxssing, please provide the infrrctnation in Ilia format ettd ordtx desaihed in this fain. <br />GENERAL OPERATION INFORMATION <br />Type or prier clcarty, io the apace provided, ALL ioformatron described below. <br />1. Ao oRcandonerator or eomoao-~' name (game to be ased on oermitl: MS Forest , LLC . <br /> 1.1 T)yeoforganiaation(corporation.parmership,etcJ: Limited Liability Corp. <br />2. Otx ration name (oh.mMe or ahe aamet: MSF\Feiater Pit #1 <br />3. Per mitted acrcaee (new or ettistiwte slte): 9.9 9 permitted acres <br /> 3. I Cltetrge in acxeage (+) 0 - 00 ~~ <br /> 3.2 l'otai Acreage in Permit Area .- 9.99 acres <br />4. es: <br /> 4.l New Application: 1094.00 application fce <br /> Amendtttrnt Fa {C.R.S. 3432.5-125(II)): ~,D application fee <br /> 4.2 Canveration Fce (from I l Od to 110 5875.(10 eatversion fa (Rule 1.11.2{2)) <br />5. Primarvmmmoditkfaltobemitred: S~___ gravel borrow <br />5.1 Incidental comatafide(s) to be mints: 1. / Ibs/Torrs/vr 2. / Ilrs/fons/yr 3. _. ! ]bs/TonsAr <br />4. / lbs/1~ 5. / lbsJfottshr <br />5.2 Anticipated erxl use ofpritnary cexemExlitie(s)lo be mmcd: ronExtn,r• inn ma E+ri ate <br />Anticipated end use of incidental cortunodilic(s) to be mired: <br />OfaE+ d OfBca d Cokrado <br />Mined Land Redansation Move and IttaclNe Mmes Geological Su^'eV <br />