2008-05-05_PERMIT FILE - M2008027 (2)

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STATE OF COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY Department of Natural Resources 1313 Sherman St., Room 215 Denver, Colorado 80203 Phone: (303) 866-3567 FAX: x:303) 832-8106 /0- ZDOB--D-;17 ,® COLORADO D I V I S I O N or RECLAMATION MINING SAFETY CONSTRUCTION NIATERIAI..S NY 0 5 2008 ?itter. Jr. LIMITED IMPACT (I 10) OPERATION DIVvisiIS70 on of Kec1q?8tiO 6' i R o?ernor 9 and Safety Harris D. Snerrian RECLAMATION PERMIT APPLICATION FORM Executive Directo- Ronald W. Cattanw Division: Director CHECK ONE: There is a File Number Already Assigned to this Operation Natural Resource Trust Permit # _ M - - -? (Please reference the file number curTently assigned to this operation) X New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Conversion Application (Rule 1.11) Permit # M (provide for Amendments and Conversions orexisting permits) The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the Office. and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application tee. When you submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies of Exhibits A-J Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the application fee described under (4) below. Exhibits should NOT he bound or in a 3-ring binder: reaps should be folded to 8 1/2" X 1 I" or 8 112" X 14" size. To expedite- processing, please provide the information in the ti rinat and order described in this form. GENERAL OPERATION INFORMATION 'T'ype or print clearly, in the space provided, ALL information described below. Applicant/operator or company name name to be used on ermit : Black Diamond Minerals, LLC 2. 3 1.1 Type of organization (corporation, partnership, etc.): Limited Liability Corporation Operation name (pit, mine or site name): Tepee Park Ranch Shale Borrow Pit Permitted acreage I new or existing site): ?. I Change in aereatie (' ) 3.2 total ,create in Permit Area 4. Fees: 4A New Application: Ar ti,dinent 1='e e f t_`.R.S. 34-_i2.5- i _..,% 4,2 Conversion Fee iftorn I I0d to 110 $1.2%00 EcSta elsiorl fee (Mule 0.66 _ permitted acres acres 0.66 acres S1,25&00 applic t1 `-e $827.00 appli _ : c,= t , , 5. Primary commoditie(s) to be mined: Shale and Siltstone Bedrock 5.1 Incidental commoditie(s) to be mined: 1. Ibs_ TOn ? 2. lbsi-nsryr 3. 4. lbs. Ions yr `• lbs' Tolls%yr 5.2 Anticipated end use of primary commoditie(s) to be mined: Road surfacing material Anticipated end use of incidental cotnmodi6elsj to be r imcd: Not applicable Ibs, `l ons: yr Office of Office of Mined land Reclamation Denver • Grand Junction • Durango Active and Inactive Mine;