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<br /> orr -STATE <br />tr-'COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />i-AllArnr»eni of Natural Re?ourCes <br />1 i 13 Sht•rman St.. Retpm 215 <br />Ov-vr. Coloradu 80201 <br />Phone- i M 1) 86h•3567 <br />FAX: (1().;) 832-81(16 <br /> DEPARTMENT OF <br /> NATURAL <br /> CONSTRUCTION MATERIALS MSOTRCES <br /> REGULAR (112) OPERATION Rov Romer <br /> RECLAMATION PERMIT APPLICATION FORM Governor <br /> lames S. Lochhead <br /> Executive Director <br /> Michael B. Long <br /> Division Director <br />FECK ONE: New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />X Conversion Application (Rule 1.11) <br />Permit k M - 93 - 088 - (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 IVORY 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 />4.1 New Application S1,875.00 application fee <br />4.2 New Quarry Application 52,325.00 quarry application <br />4.3 Milling Application (Non-OMO) 100100.00 milling application <br />4.4 Amendment Fee S590.00 amendment fee <br />4.5 _ Conversion to 112 operation (set by statute) _ $1,875.00 conversion fee <br />5. Primary commoditie(s) to be mined: GRAVEL <br />5.1 Incidental commoditie(s) to be mined: 1. lbs/Tons/v- <br />2• / lbs/Tons/vr 3. / lbs/Tons/vr <br />4. / lbs/Tons/yr 5. / lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: UNTIL PERMITTED ACRES <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: DEPLETED <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />1. A Iicant a ator or c an name name to be used -on _permit): <br />--BACA COUNTY ROAD &BRIDGE DISTRICT #1 _ <br />1.1 Type of organization (corporation,-partnership, etc.): COUNTY <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: 84-6000744 <br />2. operation name (pit, mine or site name): GUNKEL PIT NO. 31 <br />3. Permitted acreage (new or existina site): 9.025 permitted acres <br />3.1 Change in acreage (+) 150.975 acres <br />3.2 Total acreage in Permit area 16n_000 acres <br />4. Fees: