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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 a ` <br />Denver, Colorado 80203 A I CO ' I S S L R A D O <br />1 0 N O F <br />Phone: (303) 866-3567 SEP 12 ?008 RECLAMATION <br />FAX; (303) 832-8106 M I N I N G <br />SAFETY <br />CONSTRUCTION MATERIALS ?/. <br />t+, t? t ? Sill Ritter, Jr. <br />LIMITED IMPACT (110) OPERATION ?! Governor <br />Harris D. Sherman <br />RECLAMATION PERMIT APPLICATION FORM Executive Director <br />Ronald W. Cattany <br />Division Director <br />CHECK ONE: _ There is a File Number Already Assigned to this Operation Natural Resource Trustee <br />Permit # M : ?- t?.GJ (.Please reference the file number currently assigned to this operation) <br />Y New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M - - T (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (])the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 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(1)(b); and (3) the application fee. When you submit your application, be <br />sure to include one (1) cp=lete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies <br />of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for <br />die application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1/2" X <br />11" or 8 1/2" 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 described below. <br />1. Apolicant/ooerator or company name (name to be used on permit): 1 1?c r 4Ci9 fALx ?? <br />1.1 Type of organization (corporation, partnership, etc.): <br />2. Operation name (pit, mine or site name):._ <br />3. Permitted acreage (new or existing site,): permitted acres <br />3.1 Change in acreage acres <br />3.2 Total Acreage in Pertnit Area acres <br />4. ]" e <br />4.1 New Application, 1 00 application fee <br />Amendment Fee (C.R.S, 34'-32.5-125(11)): 827.00 application fee <br />4.2 Conversion Fee (front I IOd to 110 1,258.00 conversion fee (Rule 1, 11.2(2)) <br />5. Prirnarv commoditle(s) to be milted:( c4y-cl._ <br />5.1 Incidental commoditie(s) to be ruined: 1. 1 lbs/ Ionsiyr 2. _ _l__ ,_ Ibsl Cans r 1-1. __ lbs!Tons/yr <br />4. lbs".Cons/yr 5. lbsn.Ions/yr <br />5.2 Anticipated end use of primary comtoditie(s) to be mined.- <br />Anticipated end use of incidental commoditie(s) to he mined: <br />Office of Office of <br />;`finer.! Land Reclamation Deriver • Grand Junction • Durango Active and inactive ivories