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RECEIVED <br /> <br /> MAY 0 7 2001 <br /> S rATE OF CC~'~ "-° ~ et Is~Gga~gy <br />V <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St., Room 21 i <br />Denver, Colorado b0203 0 l v I s I o N o r <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS MINERAL S <br />FAX: (303) 832-8106 REGULAR (112) OPERATION `S` <br />' <br /> GEOLOGY <br /> RECLAMATION PERMIT APPLICATIO N FORM RECLAMATION <br />MINING•SAFETC <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Permit # M ~-~-_ (Please reference the file number currentty assigned to this operation) <br />%New Application (ILule 1.4.5) <br />Amendment Application (Rule 1.10) <br />_ Conversion Application (Rule 1.11) <br />Permit # M -! (provide for Amendments and Copversions of existing pemtits) <br />Bill Owens <br />Governor <br />Greg E. Walther <br />Executive Director <br />Michael 9. Long <br />Division Director <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhtbits A-S, Addendum I, any sections of Exhibit 6.5 (Geotechttical Stability Extubit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete signed and notarized IVORY ORIGINAL and four (4) copies of the completed Ivy <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical 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 [o <br />$ 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 ~ a, 3 tFtF. DO <br />Type or print cieariy, in the space provided, all information described below. ~~~ Sb~ <br />1. AppGcapt/operator or compapy name (name to be used on permR): ~ a~ ~_Ut [{i~ <br />Owens Brothers Concrete Company <br />1.1 Type of organization (corporation,parmership,etc.): Corporation <br />1.2 I.R.S. Tax I.D. No. or Sociat Security Number: 84-057-0380 <br />2. Operation name (pit, mine or site Hamel: Nix Sand and Gravel "line <br />3. Permitted acreage (new or esistipa skel: <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 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 commoditie(s) to be mined: nand and gavel <br />312 petmitted acres <br />0 acres <br />312 acres <br />$2.344.00 application fee <br />$2 406.00 quarry application <br />$1.938.00 amendment fee <br />$2.344.00 conversion fee <br />5.1 Incidental commoditie(s) to be mined: I. / Ibs/Tons/yr 2. / Ibs/Toas/vr 3. / Ibs/Tons/vr <br />4. / ]bslfons/~ 5. / lbsfloos/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Construction aggregate <br />5.3 Anticipated end use of incidental commoditie(s)tobenrined: 1•ione anticipated <br />