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<br />DIVISION OF MINERALS AND GEOLOGY <br />fhh,.trtmenl of Nalural Revources <br />I i 13 Sht-rman St., Room 215 <br />0enr4Ly, ColorstW 813203 <br />I'hunr.• 0111 Bbb-3567 <br />FAX: (11).11 932-811)6 <br />STATE 'COLORADO <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />Rov Romer <br />Governor <br />James S. Lochhead <br />Executive Ortector <br />Michael B. Long <br />Division Director <br />CHECK ONE: New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />X Conversion Application (Rule 1.11) <br />Permit 1) 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 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 />GENERAL OPERATION INFORMATION <br />Type or Print clearly, in the space provided, ALL information requested below. <br />a==?=a==na==?=====a==q=c===aavac <br />i. A licant a ator or c an name name to be used on permit) <br />BAACA 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): 9.025 permitted acres <br />3.1 Change in acreage (+) 150,975 acres <br />3.2 Total acreage in Permit area 160.000 acres <br />4. Fees: <br />4.1 New Application S1,875.00 application fee <br />4.2 New Quarry Application $2,325.04 quarry application <br />4.3 Milling Application (Non-DMO) S3,100.00 milling application <br />4.4 Amendment Fee 51,5 0.00 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. - Ibs/Togs/v- <br />2• / Ibs/Tons/vr 3. / lbs/Tons/vr <br />4. / lbs/Tons/ r 5. / lbs/Tons/vr <br />5.2 Anticipated 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