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7 <br />STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Re.$0=95 <br />1313 Sherman St., Room 2IS.: Denver, Colorado 130263 <br />Phcne: (303) 8663567. 979188 6/25/2008 3:24 PM Linda Daley <br />FAX: 1303) 832.81 Q6 I of 7 ]PER R$36.00 D$0.00 - Laplata County Clerk <br />inc Pnn DDW LIMITED, IMPACT (110) OPERATION <br />COLORADO <br />D I V 1 5 1 t? N U r <br />RECLAMATION <br />MINING <br />FAA e TY <br />Bill Ritter, Jr. <br />Governor <br />Hvurk D. Sherman <br />RECLAMATION PERMIT APPLICATION FORM Executive D;rt-aor <br />Ronald W. Cartzc: <br />... .. Divuu>n Dirtyr,r <br />Ci I ECK OSI'li: There III a Fie Number Already Asslgued to this Operation. Nrwrai Ruwurcv tnst- <br />Permit # _ (Fiesst. rcfrrattce t4a fife piuttb>rr currently assigned to-this operation) <br />_ New Application (lino 1.4.5). Atrtendaaent Application (Rule 1. 10) <br />Conversion Application (Kula 1.11) E <br />Pertrrrit, M: (ptuvkb for Anteadigentsiand Conversions of.existing permits) <br />The application for a Construction Materials Limited Imj pPact(110) Operation Rachimadon Permit contains three major Parts: (])the <br />.. <br />application form; (2) Exhibits A-J, Exhibit 4 Addendum 1, anysoetions ofF.xht'bIt6.S and Geotechnical Stability Exhibit, as required <br />by the Office, and outlined in-Rules 6.1,6.2,6,3; 6.5, and 1,6.2(IXb), an<f Q) tltoapplreahon fee: When you submit your application, be <br />sure toincludeone(1)corp IneCcj;gn`dandnott3rizedORIGINALantlope(1)gopy0ftlutcautpletednpplicatioriform,hvo(2)copies <br />ol'Lxhibits A=J; Exhrbrt L, Addetdum,l,.aadapproprwtoaacporr of6,S (t3aoooeWticaf $ b4ltty Exhibit), as required, and a check for <br />the applicatrorr f4o deap 41atIp(4)tbe?vYnt i. tbo bowtd9f?n 3-tu?? binderinaps should be folded to 8 1;2" X <br />I V or 8 X 14" stzc To expodito. processlag; P prow tu?fotatatwn iri t?e format arc bY¢Gr?dcscrrbed to this fornt.: <br />. _ a: iii.. ?.. ; .aty r4r c?lrb?aarot?.t?ntaornlticftl'3nn?".?iai...n: .. - ._ >-•-,4,•, -. •:-. , _. ____... ._ : . <br />OBNF.A1?Ql'8,1tAO1FOlt4?N 1. ` ` f tr <br />:;r -:••a•?,t+ tl .kC?'Nl-..xa.. v ...CSC t -lT,*,T <br />w <br />fype,or print cleurty, la the apace p);Qvtded,' ALL W0rwaUon descriQ below. <br />1.1 Type of organization (corpOW1011, pttctaars e4c.)' .;RL ?'? -- <br />2. Operation name (nit: mine or site narrts?: 0?,•C_n4r?7 A.?5A 30 1 l/l S I n.J <br />3. Permitted acreaee fncw or existingsitel permitted acres <br />3. l Change to acreage (+)'' , ' I acres <br />3.2 'Total Acreage to Permit Area t1.a-'E tie' - ?• 5 _ acres <br />t' 4. pees: N <br />. 4.1 N Application 1,258.130.. application tee <br />Amendmen(Fee (C R.S 34.32 5.125(!1)). 29.0 - application Ii <br />u tee (Rule 1 1 11(2)} <br />4.2 Conversion Fee (from! 10¢ to 110 converstW <br />5. Primarv contmuditiefs) tube mined. <br />Ibsl1'ons/vr•`-2. slTotts/vr I'.- bs`1'onvr <br />5.1 lncideittal cotrinwdttie4s) to be ?nt?ed. '1 ? / 1b 3 <br />. s t rt e: l ;r?3tr? rr /T'. r <br />9 l <br />lb-1 Toll&,ya r1 <br />C• '.2(Anticipated end use of primary conttaoiitde(s) to be AtJi2Cd ±"' 1tc?:1??L? ==T-!:_ n ??.1(l f <br />... l ' ', t , a •' . j 1 ? +' tllra acrC' Cc rre?. ? t !t * t a,?? n tC. ?f tl16t?0l) tt, +tr I:/ r * i i 1 <br />:ladcipateci end usa:of incidental cotryttodWe(s) w be imteieed.. ?r?'?ACli'C ` ?.!1c?<_ C?C? ?_ . 1 <br />... ,.. ' .._.. '? J r r!:''r ?•. :?'. .:fir, .. .. <br />Office of ti . QI'fi2 ti of ... <br />.e;ned Land Reclamation Denver • Gr ).unctlow.9 Duraw'.. Active and inat:tivti niioei <br />lz rVAJ ??.' IZES'S 7WJJG?lr-u fk i ?.?y 1g80 ?,?,? 418, DUA,9Q6C:;P, Co 8t3a/