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<br />• 0 <br />HATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />RECcI VED <br />1313 Sherman St.. Room 213 <br />l 1 5 1 0 N O F <br />Denver. Colorado 80203 MAY 18 2?Y? 0 v <br />Phone: {303) 866-3567 MACONSTRUCTION MATERIALS 1 1t O M I N E RA L 5 <br />FAX: 130318322.81.810 06 REGULAR (112) OPERATION & <br />Division of Minerals and Geolo jG E O L O G Y <br />RECLAMATION PERMIT APPLICATION FORM R E C L A MA T I 0 N <br />AINiNG•SAFETY <br />Bill Owens <br />CHECK ONE: There is a File Number Already Assigned to this Operation Governor <br />Creg E. Walther <br />Permit # bI - 7 7 - 485 -, (Please mfes+eoee the file cumbercutreatly assigned to this operation) Executive Director <br />New Application (Rule 1.4.5) Michael P. Long <br />Amendment Application (Rule 1.10) Division Director <br />X Conversion Application (Rule 1.11) <br />Permit # i _--ZZ-- 485 - (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 of Exhibit 6.5 (Geotechnical Stability Exhibit. and (3) the application fee. When you submit your <br />application, be sure to include one (1) ccomolo signed sad no%n_¢g IVORY ORIGINAL and four (4) copies of the completed vo <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 I V 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 provided, all information described below. <br />1. AAg <br />BA lka_nUoMrator or company as re (game to be used on Permit): <br />CA (AUNTY <br /> 1.1 Type of organization (corporation, partnership. etc.): GOVERNMENTAL ENTITY <br /> 1.2 I.RS. Tax I.D. No. or Social Security Number: R4-6000744 <br />2. Operation name (ait, aunt or site name): GRAVEL PIT NO. 8 <br />3. Figm d ted acreaEe (new or existing site): 4.1 permitted acres <br /> 3.1 Change in acreage (+) 155.9 acres <br /> 3.2 Total acreage in Permit area 160.0 acres <br />4. Fees : <br /> 4.1 New Application 52.344.00 application fee <br /> 4.2 New Quarry Application $2.906.00 quarry application <br /> 4.4 Amendment Fee S I amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) $2.344.00 conversion fee <br />5. Primary commoditle(s) to be mined: SAND GRAVEL <br /> 5.1 Incidental commoditie(s) to be mined: 1. / Ibs/Tons/vr 2. / lbs/I'o ns/vr 3 <br />/ lbw T <br /> . ons?r <br /> 4. / &9!QA26r 5. / ibs/T ons/vr <br /> 5.2 Anticipated end use of primary commoditie(s) to be mined: WHEN SAND/GRAVEL IS DEPLETED <br /> 3.3 Anticipated end use of incidental commoditie(s) to be mined: NIA