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? <br />? BIINItl191NIIN <br />999 <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St.. Room 215 <br />Denver. Colorado 80203 <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS <br />FAX: (3031832 8106 REGULAR (112) OPERATION ??/? ?O <br />RECLAMATION PERMIT APPLICATIfJ?jgRM I8 <br />?o-14fi,?a'84 ? <br />aq?GB% <br />C1?CK ONE: There is a Fik Number Already Assigned to this Operation O <br />Permit # 1?- 78.225. L (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />X Conversion Application (Rule 1.11) <br />Permit # M .78 _225 _ L (pie for Amendments and Conversion 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 sectious of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) eomalete signed and notarized IVORY ORIGINAL and four (4) copies of the completed ivory <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 M be bound or in a 3-ring binder, maps should be folded to <br />8 1/2" X 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 prov(ded, all information described below. <br />AugUcant/ooerato or SMO nr name (Rams to be used on nermh): <br />-BACA COUNTY <br />1.1 Type of organization (corporation, partnership, etc.): GOVERNMENTAL ENTITY/ROAD & BRIDGE DISTRICT III <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: 84-6000744 <br />Qw ii-ew '616 <br />2. Opel rttion dame (nit mine or site name): McVEY PIT "TPO:-- E6 4A*' <br />3. Permitted pe reaee (new or esJisdm site): 6-5Z permitted acres <br />3.1 Change in acreage (+) <br />151.43 y acres <br />3.2 Total acreage in Petmit area 160.00 aces <br />4. Fees: <br />4.1 New Application 52.345.00 application fee <br />4.2 New Query Application 52.906.00 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 convessiee fee <br />5. Prlmarv commoditie(s) to be mined: SAND GRAVEL <br />5.1 Incidental commoditie(s) to be mined: 1. / lbslfo» slur 2. I )bs/Eon fhT 3. 1 Iba/t'M& <br /> 4. ! Ibs/fonsbr 5. <br />agff <br />5.2 Anticipated end use of primary commoditie(s) to be mined: <br />-UNTU DP LY IS DEPLETED <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: N/A <br />A'-? <br />DIVISION O• <br />MINERALS <br />GEOLOGY <br />.RECLAMATION <br />MINING-SAFETY <br />j%pill <br />Bill Owens <br />Governor <br />Greg E. Walther <br />Executive Oirecror <br />MiChael8 Long <br />Division Oueaor <br />1