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<br />III IIIIIIIIIIIII III • <br />999 <br />STATE.OF <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman SI.. Room 21 5 <br />Denver, Colorado 00203 <br />Phone: 1703)8663567 <br />FAX: X3031 8328106 <br />~~7,3`li~. ©a <br />~~y~a~ <br />COLORADO <br />ECEIVEa ~~ <br />MAR 0 9 2001 <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION Division of Minerals and Geology <br />RECLAMATION PERMIT APPLICATION FORM <br />DIVISION O~ <br />MINERAL) <br />be <br />GEOLOGY <br />0. E C E A M A T I O N <br />~MINING•SAFETY <br />Bll Owens <br />Governor <br />Cl{ECK ONE: There is a File Number Already Assigned to this Operation <br />Greg E. watcher <br />Permit # M ~b0 - ~I -_ (Please reference the fde number currently assigned to this operation) E.ecuo~e Director <br />X New A lica[ion Michael B Long <br />pp (Rule 1.4.5) _ Amendment Application (Rule 1.10) Division Director <br />Convesioo Applicatiou (Rule 1.11) <br />Permit # M - ~ _ (provide for Amendments and Conversions of eeisting permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major patYS: (I) the application form; <br />(2) Exhrbits A-S, Addendum 1, any sectiotts of Exhibit 6.5 (Geotechnical Stability Exhiba: and (3) the application fee. When you subtttit Your <br />application, be sure to include one (1) complete sired and notarized IVORY ORIGINAL and four (d) copies of [he 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 to <br />8 I/2" X 1 I" or 8 1/2" X 14" size. To expedite processing, please provide the information iu the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, aD information described below, <br />I. AooDcaetionerator or comoanv Dame (name to be used o0 permit): <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />1.2 I.R.S. Tax I.D, No. or Social Securirv Number: <br />2. Operation name (nit, mine or site Dame): Lohnann Sand and Gravel i•fine <br />3. Permitted acreage (new or evstin¢ site): 82 permitted acres <br />3.1 Change in acreage (+) 0 acres <br />3.2 Total acreage in Permit area 82 acres <br />4. Fees <br />4.1 New Application $2.344.00 application fee <br />4.2 New Quatty Application $2.906.00 quarry application <br />4.4 Amendment Fee $1.938.00 amendment fee <br />4.5 Conversion to 1 12 operation (set by statute) $2.344.00 conversion fee <br />~. Primary commoditie(s) to be mined: sand and gravel <br />5.1 Incidental commoditie(s) to be mined: I. / Ibs/I'ons/yr 2. / Ibs/Cotts/vr 3. / Ibs/I'ons/vr <br /> 4. / lbs/fons/vr 5. / Ibs/Tons/vr <br />5.2 Anticipa[edenduseofprimarycommoditie(s)tobemined: Construction aggregate and concrete <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: None anticipated <br />