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STATE OF COLORADO <br /> DV11" [1On I mot;;ERr`ur es D GFOIOGY RECEIVED <br /> I )i 1 1I'e1ron St . R,o, 215 <br /> Der•.er t/02U3 JAN 12 2001 D V 1 3 1 0 � O r <br /> Phi^e ;-13. 9M6.35h: M I IN E RA L <br /> Fie , fit f:1432.6I0o <br /> Division of Minerals and Geology G E OL O G )i <br /> i EC'. A AT f CN <br /> CONSTRUCTION MATERIALS niN'N-v-S.rEr- <br /> REGULAR (112)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM <br /> Cn.e'wr <br /> f;re,t w�IrPb <br /> E.ec,,-•e D.reao, <br /> CHECK ONE: X New Application(Rule 1.4.5) Amendment Application Rule 1.109`h"'a <br /> Conversion Application(Ru!e 1.1 1) <br /> Permit# M _- l•�Qa-_ (provide for Amendments and Convey loos o`existing permits) <br /> The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts:(1) the application form: <br /> (2)Exhibits A-S,Addendum 1,any sections of Exhibit 6.5(Geotechnical Stability Exhibit;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 Ivory <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 /> .he 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 ) 2" X 11" or 8 I/2" X 14" size. To expedite processing,please provide the information in the format and order described in this form. <br /> G ATION INFORMATION <br /> Type or print clearly,in the space provided,ej,);e informatioa requested below. <br /> 1. A policant/operator or eomnanv name(name to be used on permit): WEST END GRAVEL COMPANY <br /> 1.1 Type of organization(corporation,partnership,etc.): CORPORATION <br /> 1.2 I.R.S.Tax I.D.No.or Social Security Number: 84-1258280 <br /> Oaerstloo name foil,moat or site name): WEIMER ONE GRAVEL <br /> 3. Permitted acreage(pew or existing site): permitted acres <br /> 3.1 Change in acreage(+) acres <br /> 3.2 Total acreage in Permit area 42 .9 acres <br /> :. ....................... s2,344 .00 <br /> 4.1 New Application ... ............................. StEM 00 application fee <br /> 4.2 New Quarry Application S2.325.00 quarry application <br /> 4.3 Milling Application(Non-DMO) S3.100.00 milling application, <br /> 4.4 Amendment Fee S1.550.00 amendment fee <br /> 4.5 Conversion to 112 operation(set by statute) S 1.875.00 conversion fee <br /> 5 Primary commoditle(s) to be mined: SAND & GRAVEL <br /> cubic yard;—(—Cy)/Yr. <br /> 5.1 Incidental commodities)to be mined: I. EARTH . 50,000dhsG�om.'vr 2. / IbsrTonslvr <br /> 3. / Ibs/Tons/vr 4. / Ibs/Tons/vr 5. r IbsfTons)vr <br /> 5 2 Anticipated end use of primary commodities) to be mined: ROCK AGGREGATE <br /> 5.3 Anticipated end use of incidental commoditie(s)tobemined: EMBANKMENT, IMPERVIOUS LINER <br />