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STATE OF COLORADO <br />DIVl510N OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 21 S <br />Denver, Colorado 80203 C O L Ot o A l o0 <br />Phone: (303? 866-367 RECLAMATION <br />FAX: (303? 832-8106 CONSTRLCTION MATERIALS M I N I N G <br />REGL;L.AR (112) OPERATION SAFETY <br />RECI,AMAT[ON PERMIT APPLICATION FORM <br />Bill Ritter, )r. <br />Governor <br />CHECK ONE: There is a File Number Already Assigned to Ibis Operation Harris o. sl,emwrt <br />Executive Director <br />Permit # 1~1 - - -_ (.Please reference the; file number currently assigned to this operati~o~,ald w. caiWt,y <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Division Director <br />Natural Resoure:e Tnistee <br />Conversion Application (Rule 1. I l ) <br />Permit #. -_ Vt -_~~: : __--~ (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.S (Creotechnical Stability Exhibit; and (3) the application tee. When you <br />submit your application, be sore to inctude one (1) complete signed and notarized ORIGINAL and one (t} copy of the completed <br />application form, two (2j copies ofExhibits A-S, Addendum 1, appropriate sections of6.S (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; maps should be folded to <br />8 l i 2" X I 1 " or 8 t!2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENE[tAL OPERA'tiON 1:'VFORi4fAT[ON <br />'t'ype or print clearly, in the spate provided, AI.1, information requested below. <br />Applicant/operator or company name (name to be used on permit): ~1PaK.EN ~RRo(.u ~N//~ST/j1E,t/TS LLe. <br />1.1 Type of organization (corporation, partnership, etc.):..~•n.!rE,o ~/~',Bj~1Tl~_ /yJ~ <br />Operation name (pit. mane Or site nantei: GPO ~/ T <br />2 <br />. <br />3. .Permitted acreage (new or existing sitel: ~ . ~ permitted acres <br />3. i Change in acreage (+) acres <br />3.2 Total acreage in Pern~it area __~LS_ ~L_ __.__ acres <br />4. Fees: <br />d.l Nc~v Application 52.695.00 application fee <br />4.2 Ivety Quarry Application. 53.342,08 ypam~ application <br />4.4 rlrnendme;nt 1`ee 52,229.,Q0. arnetultrettt fee <br />~#.5 C`onversion tti t 12 [~perati.ott (set by stat4.lte) ~2,a96.00 conversion fee <br />5. Primary commoditie("s) to be mined: ~~Pf~~~ ---~/.~tUQ---- -IEL' - --.--.--.- <br />5.1 Incidental comrttociitie(s) to be nrined: 1:.~~iQ_._~..._.________tbsi E;~ngr~T 2. _. .....____.___.._.___._ _. Ibs/7"uns/yr <br />3. __ ! lbs/'fonsyr =1..~- -.__ '-_._~..__ Ibs:`'I'ons?yr 5• -__._..._._.%-__------- lbs~`Tonuyr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: _~Q~/~_,~~lL`j/d.t/ _/~'~//,~~.____--__-_.__....._.- <br />5.3 Anticipated end use of incidental. carnmoditie(s) to be mined: __~I~__ _~____ __ __~_._-_-.-.. <br />Qffit[:. of C)ltice Ut <br />Mined Land Redamatiort Denver Grand )unction -Durango A[:Iive ttncl Inactive Mines <br />