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DIVISION OF RECLAMATION, MINING AND SAFETY
<br />Department of htaturaf Resources
<br />1313 Sherman St., Room 215
<br />Denver, Colorado 80203
<br />Phone: 1303) 866-3567
<br />FAX: 003i 832.8106
<br />STATE OF COLORAD-0 Pep oAt?
<br />O`/
<br />-' X200
<br />? ; -'ti-p • Leo,^, ? 8
<br />`f,vor, CONST.Ri.`C"['ION ,13ATERr d 0, lalQ C
<br />?\s\o?p? LrVrI'I'F.r) IMPACT (110) OPERATION afe? Q,
<br />?r? RECLAMATION Pr?RiVrIT APPLICATION FOR 1
<br />
<br />C O L O R A D O
<br />t) I V I S t Q 's o r
<br />RECLAMATION
<br />MINING
<br />SA ETY
<br />3itl Kitten, Jr
<br />Governor
<br />Har,-is D. Sherman
<br />Executve Direr*or
<br />Ronald W. Catiany
<br />pivisipn 04eoor
<br />CHECK ONE: -_ There is a File Number Already Assigned to this operation N iturai Resourcf- Tru;tec.
<br />Permit # M --OW (Please reference the file number currently assigned to this operation)
<br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10)
<br />Conversion Application (Rule 1.11)
<br />Permit # -- t (provide for Amendments and Conversions of existing permits)
<br />The application for a Construction Materials Limited Impact (110) Ope.:ation 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 Geotechnicai 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 tee. When you submit your application, be
<br />sure to include one (1) complete signed and notarized ORICINAL 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 (Geotechnicai Stability Exhibit), as required, and a check for
<br />• the supplication fee described under (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1 i2" X
<br />11" or 8 l12" X 14" size, To expedite processing, please provide the information in the format and order described in this form.
<br />GENERAL OPERATION 1NFORMXI'ION
<br />Type or print clearly, in the space provided, ALL information described below.
<br />1. Applicant/operator or company name (name to be used on permit):
<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 sites:permitted acres
<br />?.1 Change in. acreage (s) acres
<br />3.2 Total Acreage in Permit Area ?z ?? --- acres
<br />4. Fees-
<br />4.1 N -x Apphcaii(m: S1,258,00 :a.pplic-alwn Jet,
<br />.erne fnx'acnt Fec.It..'A.?.314-325 r '5(11 1, LIPPIi atiuo l".c
<br />4,2 Conversion Fee (from I ltld to 1 tc} ?I.ZS?t.itl o}}4c rs€€tr, to x, (Rule 1.11.1;!))
<br />5. Pr•imarv commoditie(s) to be nrined: /1C(,rm4l"Vo,_-?/)1'(,(
<br />5.1 incidental cortnnoditie(s) to he rni}ted: I..__..._.!...? Ibs;_fous'yr 2. ........... .... '............. ...)hs!a"ons,'yr 3. ..._..........! .__.-._._ lbs•!"1J_ons/vT m2 Y!
<br />4. lbs/Totn/w 5, _r
<br />5-2 Anticipated end use of primary cornmoditie(s) to be mined:
<br />• mic p-all 1 end 11sc rf mcider tal cornir c stie(s) to 1?e n _rced:
<br />office. of of
<br />r4lined 1_aild Reclamation Deriver • Grand Junction • Durango Acxire end lnactivo, Mine<
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