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TATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />RECEIVED <br />Department of Natural Resources <br />t373 Sherman St., Room 215 <br />Denver, Colorado 80203 C <br />ONSTRUC'TION MATERIALS MAR 2 4 2004 <br />~ <br />Phone: (303) 866-3567 <br />/ <br />FAX: (303) 832-8tD6 REGULAR (112) OPERATION <br />Division of Minerals & Cealapy <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: There is a Fite Numher/flraady Assigned to this Operation <br />Permit # M - oe ~_-Q ZZ(P//lease reference the file nutnber cturendy assigned to ttus operation) <br />%NewApplication(Rule1.4.5) _AmendmentApplication(Rule1.10) <br />_ Conversion Application (Rule 1.11) <br />Permit # Iv _-_ -_ (provide for Amendments and Conversions of eXisting permits) <br />COLORADO <br />DIVISION O F <br />MINESRALS <br />GEOLOGY <br />0.ECLAN AT ION•NINING <br />SAFETY•$CIENCE <br />6111 GWen$ <br />Governor <br />Greg E. Walther <br />Executive Director <br />Ronald W. Cattany <br />Division Director <br />Natural Resource Trustee <br />The application for a Consttnction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendtm I, any sections ofExhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submityol>r <br />application, be sure to include one (1) complete sipped and notarized IVORY ORIGINAL and one (1) copy ofthe completed [~ application <br />form, two (2) copies ofExllibits A-S, Addendum 1, appropriate sections of 65 (Oeotechnical Stability Exhibit, and a check for the application <br />fee described tender Section (4) below. Exhibits should NOT be bound or in a 3-ring binder, maps should be folded to 812" X 11"or 812" X <br />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 ckarly, in the apace provided, ALL information requested bebw. <br />1. ADDlicant/oceratorormmoaevname(nameto6eusedoncermitl: Hilltop Aquatic Investments, LLC <br />1.1 Type of organization(cotporation,partnerstlip,etc.): Limited Liability Company <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: <br />2. Ooerationname(oi6mineoraitenamel: Raindance Sand and Gravel nine <br />3. Permitted acreasre (new or ettiatia¢ site): 85 permitted acres <br />3. ] Change in acreage (+) acres <br />3.2 Total acreage in Petinit area SS acres <br />4. Fcea <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) $2 344.00 conversion fee <br />5. Primary commoditte(al to be mined: sand travel <br />5.1 Incidental commoditie(s) to be mined: 1. None - Ibslfons/vr 2. 1 1bslTonsly7 <br />3. ! ]bslfons/vr 4. i 1bs/Tonshr 5. / ibsllonslvr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: fop v , ion Aggr~agg and ('on r Aggrega to <br />5.3 Anticipa[edenduseofincidentalcommoditie(s)tobenlined: None anticipated <br />Office of Office of Colorado <br />Mined Land Reclamation Active and Inactive Mines Geological Survey <br />