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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 7 C O L O R. A D O <br />Denver, Colorado 80203 D i v t s [ON O <br />Phone: (303} 866-3567 RECLAMATION <br />FAX: (303) 832-8106 CONSTRUCTION MATERIALS MINING <br />REGULAR (112) OPERATION SA L <br />RECI.AIVIATION PERMIT APPLICATION FORM <br />Bill Ritter, )r. <br />Govemor <br />CHECK O.NE: There is a File Number Already Assigned to this Operation Harris 0. Shem,an <br />Executive Director <br />Permit # M - - (.Please reference the file number currently assigned to this operatigla, tiv. carranv <br />X_ New Application. (Rule 1.4.5) Amendment Application (Rule ]A 0) oivi io" Director <br />Natural Resource Trustee <br />Conversion Application (Rule 1.11) <br />Permit #. -_ 1V1 (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application tee. When you <br />submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and acheck for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; [naps should be folded to <br />8 1/2" X J 1 " or 8 1,12" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERA'T'ION INFORMATION <br />• 't'ype or print clearly, in the space provided, ALL information requested below. <br />1. Appiicantloperator or company name (name to be used on Qermit): <br />1.1 Type of organization (corporation, partnership, etc.): 6jv??7-,?? / <br />2. Operation name (pit, mine or site name): Jeee P/ 1 <br />3. Permitted acreage (new or existing site): permitted acres <br />3.1 Change in acreage (+) RECEIVED acres <br />3.2 Total acreage in Permit area acres <br /> MAR 2 5 2008 <br />4. Fees: <br />4.1 New Application Division of rteciamation, $2,696.00 application fee <br />4.2 New Quarry Application. Mining and Safety 53 342.00 quam application <br />4.4 Arnendirnnt Fee $2.229,Q0 amendment fee <br />4.5 Conversion to 112 operation (set by statute) .. $?.,f96.00 conversion fee <br />5. Primary commoditie(s) to be mined: 4 ?[? SAGA ara,,?,l <br />5.1 Incidental conintoditie(s) to be mined: I. _0/A W _ lb5%2. Ib5li( si r <br />3.._ ' lbst'1'ons,Xrr 4. ! lbs/Tonslyr 5. lbs_"Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />0 <br />Offiu_ of office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Acl:ive rind Inactive Mines