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? <br />L <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St.. Room 215 <br />Denver. Colorado 80203 <br />aiiuinian??u <br />STATE OF COLORADO <br />4 ^ <br />Phone: (303) 866-3567 CONSTRUCTION MATI?RIALS ??+? / <br />FAX: (303) 832 8106 REGULAR (112) OPERATION ?0 <br />RECLAMATION PERMIT APPLICATId?j?oRM I g 10? V <br />4jr'Bra <br />4a'aCe <br />CHECK ONE: There is a File Number Already Assigned to this Operation gI' <br />Permit # _hL- 78_ 225- L (Please reference the file number currently assigned to" 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 (provide for Amendments and Conversions of existing permits) <br />A?_? <br />O I V IS (O N O <br />MINERALS <br />GEOLOGY <br />.RECLAMATION <br />MINING-SAFETY <br />Bill Owen-, <br />Governor <br />Greg E. Watcher <br />Executive Oirecror <br />Michael a Long <br />Drvr-,ron Director <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, Am sections of Exhibit 6.5 (Geotechnical Stability Exhibit: and (3) the application foe. When you submit your <br />application, be sure to include one (1) comolete sinned 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 Exhtibit, 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 provided, all Infortnatlon described below. <br />1. Ap-ollcan loperator or gMonr name am to be used on permit): <br />BACA COLINTY <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 />F" ieSw '40 <br />2. Operation name (pit mine or site name l: McVEY PIT -W <br />O- -l-6 44" <br />3. Permitted acreage (agg or alathm sliel: 8.57 permitted steins <br />3.1 Change in acreage (+) <br />L5I.43 acres <br />3.2 't'otal acreage in Permit area _ 160.00 acres <br />4. Fees: <br />4.1 <br />4.2 New Application <br />New Quarry Application 3 S 0 application fee <br /> <br />4.4 <br />Amendment Fee 52.906.00 <br />quarry application <br />4.3 Conversion to 112 operation <br /> <br /> <br />(set by statute) <br />11,9381.00 <br /> <br />amendment fee <br /> 344.0 conversion fee <br />5. Primary ctommodithe(s) to be mined: SAND GRAVEL, <br />5.1 Incidental commoditie(s) to be alined: t. / lbslfonslvr 2. 1 )bslPo a yr 3. / lba/L nR <br /> 4. 1 lbs!fous/vr 5. / h*gon3/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: UNTIL SUPPLY IS DEPLETED <br />5.3 Anticipated end use of incidental comtmoditie(s) to be mined: N/A