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N-D) <br />STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 RECEIVED <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS <br />FAX; (303) 832-8106 <br />APR~-~ 9 2007 REGULAR (112) OPERATION <br />RBEECLAMATION PERMIT APPLICATION FORM <br />Division of Reciamapon, <br />Minin4~ and Safety <br />COLORADO <br />DIVISION O F <br />RECLAMATION <br />MINING <br />- &- <br />SAFETY <br />Bill Owens <br />Governor <br />CHECK ONE: There is a File Number ready Assigned to this Operation Russell George <br />Permit # M -•~-~- f~ (Please reference the file number currently assigned to this opera"'e Dire~ror <br />Ronald W. Cattany <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Division Director <br />Ir Conversion Application (Rule 1.11) Natural Resource Trustee <br />Permit # M -~Z-~_-~ (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 fee. When you <br />submit your applicatioq be sure to include one (1) cortlplete sitnled 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 a check for <br />the application fee descnberi under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to <br />8 1/2" X 11" or 8 1/Z" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />1. Applicant/operator or company name (name to be used on permit): ~ l ~,YL ~RQ~I-.JALt ~©Q/"C1 IdN <br />1.1 Type of organizaition (corporatioq partnership, etc.): ~'_[' f)r{!~ l D/(~ <br />2. Operation name fait, mine or site name): ~ ~~Q/f~~ ~I)a/d.~. t/ <br />3. Permitted acreage (n)ew or ezistine site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in :Permit area <br />~9, ~ ~ <br />~~~ -7~ <br />permitted acres <br />acres <br />acres <br />4. Fees: <br />4.1 New Application $2.344.00 application fee <br />4.2 New Quarry Application $2,906.00 quarry application <br />4.4 Amendment Fee $1,938.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) $2,344.00 conversion fee <br />,,~~~~ ~~ ~ r <br />5. Primary commoditie(s) to be mined:sf'iu.~~/~~~!/U1~lJ Q~jG $ <br />e+U22l~~ <br />5.1 Incidental commoditie(s) to be mined: 1. GQdf~~d7f D~ibs/Tons/yr 2. / Ibs/Tons/vr <br /> 3. / lbs/Tons/vr 4. / lbs/Tons/vr Sr. / ~ lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: ~„~.-~( uC_~,~/~.%~~r~-1~ <br />5.3 Anticipated end u;se of incidental commoditie(s) to be mined: y <br />Office of Office of <br />AAinarl I anri Rar-lamatinn Active and Inactive Mines <br />