Laserfiche WebLink
To'- b M G ~ <br />r e'. a ppi~ cafim 'i <br />RECEIVED <br />I-1- av~6-D~ <br />JUL 2 1 2006 '~ <br />Division of Minerals and Geologq <br />rn2r~c~°5a ~ <br />CONSTRUCTION MATERIALS <br />LIMITED IMPACT (110) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CIdECK ONE: <br />There is a File Number Already Assigned to this Operation <br />Permit ~vf -_ , _ (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M -_ _ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Limited Impact (I 10) Operation Reclamation Permit contains three major parts: (1) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required <br />by the Office, and outlined in Rules 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 <br />sure to include one (1) complete simed and notarized ORIGINAL and one (1) copy ofthe completed application form, two (2) copies <br />of Exhibits A-J, Exhibit L, Addendum ], and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for <br />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 <br />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 <br />Type or print clearly, in the space provided, ALL iaformatiLLon descryibed below. <br />1. AoolicanUooerstor or comoanv name (name to be used on cermitl: GOON 11Atr1 T w~ ~t 1/!.t! t ~~ Z-~.~-~ <br />1.1 Type of organization (corporation, partnership, etc.): <br />~ n <br />2. Oceration name (pit. mine or site Hamel: ~ n R ~! ~~ <br />n n <br />3. Permitted acreage lnew or existine sitel: <br />3.1 Change in acreage (+) <br />3.2 Total Acreage in Permit Area <br />4. Fees: <br />4.1 New Application: <br />Amendment Fee (C.R.S. 34-32.5-125(U)): <br />4.2 Conversion Fee (from 110d to 110 875.0 conversion fee (Rule 1.11.2(2)) <br />5. Primary commoditie(sl to be mined: G"t~4Jt' <br />r ~ r permmea acres <br />Q acres <br />_~ acres <br />1 094.00 application fee <br />719.00 application fee <br />5.1 Incidental commoditie(s) to be mined: 1. / Ibs/Tons/vr 2. / ]bs/Tons/vr 3. / Ibs/Tons/vr <br />4. / Ibs/Tons/vr 5. / Ibs/Tons/fir <br />5.2 Anticipated end use of primary commoditie(s) to be mined: - l X04 ~ S ~/'! /e W 4N S S~4S ~ 0 //l ~ <br />T <br />Anticipated end use of incidental commoditie(s) to be mined: 1 rAOh ue nr tn1<"S- <br />