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~_ <br />STATE OF CC.~LORADC~ <br />DIVISION Of RECLAMATION, MiNtNC AND SAFETY <br />Department of Natural Resources ~" k ~. u~ ~ '• <br />1313 Sherman St., Room 215 C O L O R A D O <br />Denver, Colorado 80203 ,.•_ o i v 1 s 1 o N o v <br />Phone: (303) 8b6-3567 ` • ~, RECLAMATION <br />fAX: (303) 632-8106 /,• •• ~ M I N I N G <br />_`.::..' 1 _ '•~i~, SAFETY <br />CONSTRtiCTION MATERIALS `~' <br />LINIII'Ell IMPACT (110) OPERATION SitE CTvens <br />Governor <br />RECLA~'IATION PER'VIIT APPLICATION FOIiit4 Russen eeor~ <br />Executive OircK:tor <br />Ronald VV. Cottony <br />CHECK ONE: 'f here is a File Number Already Assigned to this Uperation Division Director <br />Natural Resource Trustee <br />Pemvt # Vt - - -_ (Please reference the file number currently assigned to this operation) <br />X New Application (Rule 1.4.5) Amendment Application (12u1e 1.10) <br />Conversion Application (Rule 1.1 l ) <br />Permit ~i tit - -__ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction ~'~laterials Limited Impact (1 t 0) Operation Reclamation Permit contains three major parts: (1) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum I, any sections of Exhibit G.5 and Geotechnical Stability Exhibit, as regtired <br />by the Office, and outlined in Rules 6.1, 6.2, b.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 (t) complete signed and notarized ORIGINAL and one (1) copy ofthe completed application form, avo (2) copies <br />of Exhibits A-J, Exhibit .L, Addendum 1, 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 />I 1" or 8 lr"2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br /> GENERAL OPERATION INFORiViATIO':V <br />Type or print clearly, in the space provided, ALL information described below. <br />i. AppiicantJoperator or company name (name to be used on permit): Wes tern Grave 1 . _LLLC . <br /> 1.1 Type of organization (corporation, partnership, etc.): Corporation <br />2. Uperation name (pit, mine or site name): WRC Grave 1 P i t <br />3. Permitted acreat=_e (new or existine site): 9 . 9 9 permitted acres <br /> 3.1 Change in acreage; (~!~) acres <br /> 3.2 Total Acreage itt Permit Area 9 . 9 9 acres <br />4. Fees: <br /> 4.1 New Application: `s l {)94a)Q application fee <br /> Amendment 1 ee (C;.R.S. 34-32.5-125(Il)p. ,~71r9.00 application fee <br /> 4.2 Conversion ree (tram I lOd to I IU ~ %5.00 conversion fee (Rule 1..1 l.2(2)) <br />5. Primary commoditie(s) to be mined: Grave 1 <br /> 5.1 Incidental commoditie(s) to be mined: 1. ~ Ibs/T'ottsrvr 2. ~ ! Ibs/Tons/yr 3. _____ ! !bs/Tonslvr <br /> 4. ____ / _M_lbslTonsi~r S. / Ibs/'tons/vr <br /> 5.2 Anticipated end tise of primary commoditie(s) to be mined: Rodd Base <br /> Anticipated end use of incidental commoditie(s) to be mined: __ ____ _~~__ <br />Uffice of Office of <br />Mined Land Ret:lamation Active and Inactive Mines <br />