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IINIMINI?W k STATE (t-COLOMDO <br />DIVISION OF MINERALS AND GEOLOGY <br />Ih•1>.trtmcnl 4 N.ttural Resources <br />1 1 t S Shrvman St.. Rtwm 215 <br />Ih•nvvr, Ctd.tradu 80203 <br />11horw: I HI 11866.3567 <br />FAX: 11U.H 832.8106 <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />Ray Romer <br />Governor <br />lames S. Lochhead <br />Executive Director <br />Michael B. Long; <br />Division oirector <br />_ CHECK NE: Now Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />X Conversion Application (Rule 1.11) <br />Pezmic 4 _M_- 93 - 087 - (provide for Amendments and Conversions of <br />existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains <br />three major parts: (1) the application form; (2) Exhibits A-S, Addendum 1, any sections of <br />Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete signed and notarized IVORT ORIGINAL and four (4) <br />copies of the completed Ivor application form, five (5) copies of Exhibits A-S, Addendum 1, <br />appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application fee <br />described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps <br />should be folded to 8 1/2, X 11' or 8 1/2, X 14' size. To expedite processing, please provide <br />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 2ermit): <br />BACA COUNTY ROAD & BRIDGE DISTRICT #1 <br />1.1 Type of organization (corporation, partnership, etc.): COUNTY ROAD & BRIDGE <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: 84-6000744 <br />2. operatioa name (pit, mine or site name): WEEDEN LAND & CATTLE CO_. PIT 'NO. 30 <br />3. Permitted acreage (new or existing site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.3 Milling Application (Non-DMO) <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />9.9 permitted acres <br />150.1 acres <br />160.0 acres <br />11,875.00 application fee <br />S2.325.00 quarry application <br />_ $3,100.00 milling application <br />51,550.00 amendment wee <br />51.875.00 conversion fee <br />5. Primar y commoditie( s) to be mined: GRAVEL <br />5.1 Incidental co.Rmloditie(s) to be mined: 1. - lbs/Tons/v- <br /> 2. % lbs/Tons/vr 3. / lbs/Tons/vr <br /> 4. i lbs/Tons/vr S. lbs/Torts/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: UNTI L GRAVEL IS DEPLETED <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: