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6 0 <br />DIVISION OF MINERALS AND CE(XOGY <br />Department rii Natural Resources <br />1313 Sherman St., Rnom 315 <br />Denver, C010rado 802D3 <br />Phune: I30S) 866-3567 <br />FAX: l 1031832.81()6 <br />miommim <br />999 <br />NOY 0 s 2001 <br />Divhioa of Minerals and&8100y <br />OF COLORADO <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />Governor <br />Greg E. Watcher <br />Executive Or rector <br />Rule 1. 10'chael s. Long <br />CHECK ONE: New Application (Rule 1.4.5) Amendment Application ( ?ivifioq S. Long <br />Ditecwr <br />% Conversion Application (Rule 1.11) <br />Permit i1 `M.??_ 01q _ (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 form; <br />(2) Exhibits A-S, Addendum 1, any sections ofExhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) of A ate shined and notarized IVORY ORIGINAL and four (4) copies of the completed jyM <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described 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 (1 " 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 apace provided, ?I information requested below. PAC &!T la <br />1. AtiallcanVgRgmtor or company amme (name to be used on nermift BACA COUNTY ,35fy. 00 <br />1.1 Type oforganization (corporation, partnership, etc.): GOVSRtRtENTAL ENT117R <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: IW6000744 <br />RECLAMATION PERMIT APPLICATION FORM Bill Owens <br />2. Operstion name pit. mid or ske name): MIINDELL PIT #32 <br />3. Permkted acreage (aew or exis na site): <br />3.1 Change in acreage (+) <br />32 Total acreage in Permit area <br />4. f=: <br /> <br />DIVISION O F <br />MINERALS] <br />GEOLOGYII <br />RECLAMATIONI <br />MINING•SAFETY <br />--91,12 permitted acres <br />30 - 88 acres <br />40.00 acres <br />4.1 New Application S 1.875.Q0 application fee <br />4.2 New Quarry Application 52325.00 quarry application <br />4.3 Milling Application (Non-DMO) 53.1 OQ.00 milling application <br />4.4 Amendment Fee 51.550.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) S1,975,00 conversion fee <br />5. Primary commoditie(s) to be mined; ROAD BGD MATERIAL <br />5.1 Incidental commoditie(s) to be mined: 1. - IbjMos/vr 2. ! Ibsrronslvr <br />3. / lbs(Tons/w 4. / lbs/Tons/vr 5. / lbonSIVr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: WHEN ROAD NATERM "IS IS DEPLETED. <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: N/A