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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY RECEIVED <br />Dgmrtment of Natural Resources <br />1313 Sherman St., Room 215 APR 2 2008 <br />Denver, Colorado 80203 <br />Phone. M3'866-3567 t + Division of rleclamati( <br />FAX: 003) 832-8106 CONSTRUCTION MATERIALS Mining and Safety <br />RECE.II.AR {I 12) OPERATION <br />RECt,AMATION PERMIT APPLICATION FORM <br />COLORADO <br />T?av1elQ+t nF <br />RECLAMATION <br />MINING <br />SAFETY <br />t3i1t Ri?ter, fr. <br />` t ?I Gevemor <br />CHI-CK ONE: `here is a File Narnber Already Assigned to this Operation Hants 0. srer , <br />Executive Director <br />Permit # M -?= (Please reference the file number currently assigned to this operatic l d caz, u1y <br />New Application (Mule 1.4.5) Amendment Application (Rule 1.10) O"f ion Director <br />Conversion Application (Rule 1.11) Naturd) Resource Trustee <br />Permit # M (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 />forth; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to include vtte (1) fete signed and notarized ORIGINAL and one (1) dopy of the coanpleted <br />application form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-brig binder; snaps should be folded to <br />8 1/2" X 1 I " or 8 112" X 14" size. To expedite processing;, please provide the information in the format and order described in this fort. <br />GENERAL OPERATION .INFORMATION <br />Type or print clearly, in t11aVace provided, Al<1L. information rsyausted below, <br />1. Applicant/op erator or company name {name to be used on permit): e ZJ-?- <br />_ I ?. <br />1.1 Type of organization (corporation, partnership, etc:): r r7 t t _ l?<-t1< < <'t <br />2. Op eration Warne Ipit, mine or site name): <br />3. rerndtted acreage (new or existing site): permitted acres <br />3.1 Change in acreage (y) --`A acres <br />12 Total acricage in Permit area acres <br />4. Fees: <br />4.1 New Application $2,696.00 application fee. <br />41 New Cuarry_ plication -U N-2,00 wr aa ltcatimn <br />4.4 A.rnendrwnt Fee $-,229.00_ atnendment fee <br />4.5 Conversion, to 112 operation (sst by 8t81pitc) £ce <br />5. Primary commoditie(s) to be mined: <br />/_/Cjj <br />-----.--- <br />5.I lncfilei3taf conmaoditie(s) t4 ts,' mined: I.._ lbs;"1btr_s.?yr 2, _ i llxs omi <br /> 3..' ? lbs(ronsNr lb <br />s,"I'ons/w 5^- <br />5.2 Anticipated end use of primary commoditie(s) to be mined: [ <br />l? ? <br />V'kk C { T <br />" j <br /> <br />5.3 Anticipated end use of incidental eommoditic(s) to be rnined <br />_ y i <br />Office of Office of <br />MFI1C'Y -1.Af2L1 KtCj8fl1ilt3f3n 17£'LSver + Glaflii JLt3L"t'IOfS + ;I)ilf:7ff$43 At t:vP_ :i ifs R.tLt1kE Mille,,