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<br /> S IATE r CoLoRADo <br />DIVISION OF MINERALS AND GEOLOGY <br />Deli tnmens of Natural Resources <br />1 113 Shuman St.. Room 215 <br />Ik'nalK. CoI%16& 80203 <br />i'hone- i N111 86h.3567 <br />FAX: ( 14).11 1;3-)-81116 <br /> DEPARTMENT OF <br /> NATURAL <br /> CONSTRUCTION MATERIALS MSO RCES <br /> REGULAR (111) OPERATION Rov Romer <br /> RECLAMATION PERMIT APPLICATION FORM Governor <br /> lames S. Lochhead <br /> Executive 01rector <br /> Michael S. Long <br /> Division Director <br />2.?EK ONE. New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />X Conversion Application (Rule 1.11) <br />Permit # 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 gianed and notarized IVORY ORIGINAL and four (4) <br />copies of the completed Ivory 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 51,875.00 application fee <br />4.2 New Quarry Application 52,325.00 quarry application <br />4.3 Milling Application (Non-DMO) $3.100.00 milling application <br />4.4 Amendment Fee 21.550.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) 51.975.00 conversion fee <br />GENERAL OPERATION INFORMATION <br />Type or print clearly# in the space provided, ALL information requested below. <br />---3=-r=----=rS3==-.1?= .-..-?----=-A53==-----------25.-.?7-J ? ??--------?...-.----__ ??3--II--O-=-----?-?---_ <br />1. &mlicant/overator or comvaav cams (acme to be used on-vesmf.t):r - <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 existing site): 4,025„` permitted acres <br />3.1 Change in acreage (+) 150.97acres <br />3.2 Total acreage in Permit area 160,000 acres <br />4. Fees: <br />5_ Primary commoditie(s)_to_be mined: <br />5.1 Incidental commoditie(s) to be mined: 1. Ibs/To s/v- <br />2• / Ibs/Tons/yr 3. / lbs/Tons/vr <br />4. / lbs/Tons/ r 5. 1 lbs/Tons/vr <br />5.2 Ancicipated end use of primary commoditie(s) to be mined: UNTIL PERMITTED ACRES <br />5.3 Anticipated and use of incidental commoditie(s) to be mined: DEPLETED