PERMFILE138840

• Permit No: M1998052
• IBM Index Class Name: Permit File
• Doc Date: 6/12/1998
• Doc Name: APPLICATION FORM
• Media Type: D
• Archive: No

'
Ii
~~

• , iii iiiiiiiiiiiiiiii
STATE OF COLO~/RADO
DIVISION OF MINERALS AND GEOLOGY ~ E c-,; ~~ ~ y /
Department of Natural Resources G k ; G I'1 I~~~~
1313 Sherman St., Room 215 1,
Denver, Colorado 60203 ~~~E~ y ~D
Phone: [phone]
FA%: (3031 83?8106 DEPARTMENT OF
JUN 12 1998 NATURAL
CONSTRIICTION MATERIALS '~'•'""n ul Minerals ~ Geology RESOURCES
Roy Romer
LIMITED IMPACT (110 ) OPERATION Governor
1
CHECK ONE:
RECLAMATION PERMIT APPLICATION PORM lames 5. Lochhead
Executive Director
Michael B. Long
Division Duenor
X New Application (Rule 1.4) Amendment Application (C.R.S. 34-32.5-110)
Conversion Application (Rule 1.11)
Permit # - -_ (provide for Amendments and Conversions of
existing permits) M, c~ 1~, ®C'.Z
The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit
contains three major parts: (1) the application form; (2) Exhibits A-J, Exhibit L, Addendum 1,
any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the Office, and
' outlined in Aules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When you
submit your application, be sure to include one (1) complete"sinned and notarized IVORY ORIGINAL
and one (1) copy of the completed Ivory application form, two (2) copies of Exhibits A-J,
Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as
' required, and a check for the application fee described under (4) below. Exhibits should NOT be
bound or in a 3-ring binder; maps should be folded to 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.
----------------------------------------------------------------------------------------------
GENERAL OPERATION INFORMATION
Type or print clearly, is the apace provided, ALL information described below.
______________________________________________________________________________________________
1. Applicant/operator or company name (name to be used on ermit):
Roclc Island Land Co., LLC
' 1.1 Type of organization (corporation, partnership, etc.): LLC
1.2 I.R.S. Tax ID No. or Social Security Number:
' 2. Operation name (pit, mine or site name): Rock Island Operation
3. Permitted acreage (new or exietins site): permitted acres
' 3.1 Change in acreage (+ or -) acres
Total Acreage in Permit Area 9.9 acres
4. Fees:
4.1 New Application 5875.00 application fee
Amendment Fee (C.R.S. 34-32.5-125(II)) 5575.00 application fee
4.2 Conversion Fee (from 110d to 110 875.00 conversion fee (Rule 1.11.2(2))
' S. Primary commoditie(s) to be mined: Sand gravel road base rip-rap etc.
5.1 Incidental commoditie(s) to be mined: 1. none lbs/Tons/vr
2. / lbs/Tons/vr 3. / lbs/Tons/yr
' 4. / 1bs/Tons/vr 5. / lbs/Tons/yr
5.2 Anticipated end use of primary commoditie(s) to be mined: construction materials
' 6.3 Anticipated end use of incidental commoditie(s) to be mined: