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<br />• <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 LIS I f <br />Phone: (303) 866.3567 CONSTRUCTION M <br />ATERIALS FAX: 1303) 832-8106 REGULAR (112) OPERATION RECLAMATION PERMIT APPLICATION FORM RECEIVE <br />it C MAY 18 2001 lie ens <br />CHECK ONE: There is a File Number Already Assigned to thla Operation !? <br />Permit # 77. 4$6 ly DDIVI lona(( ofnperaisloaJa G Greg E. a Director <br />(Please reference the file number current assi W to ?" <br />Michael 8. Long <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Division Director <br />A Conversion Application (Rule 1.11) <br />Permit # - (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (t) 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 vour <br />application, be sure to include one (1) cgga etc sipped and notarized IVORY ORIGINAL and four (4) copies of the completed No <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 11" or 81/2" 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 (eformatlon described below. <br />L ADplieant/oggrator or company name name to be used on permit): <br />BACA COUNTY <br />1.1 Type of organization (corporation, partnership, etc.): GOVERNMENTAL ENTITY _ <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: 84-6000744 <br />2. <br />3 <br />O9rgtion Dame (Dit mine or site name): GRAVEL PIT NO. 7 <br />Permitted acrea¢4 (new or clhttng site): 1.7 permitted acres <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4 <br />Fees: <br />4. I New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />158.3 acres <br />160- acres <br />-12344.00 application fee <br />12,906-00 quarry application <br />11.93$00 amendment fee <br />-ILL44-00 conversion fee <br />5. Primary commoditie(s) to be mined: GRAVEL SAND <br />5.1 Incidental commoditie(s) to be mined: 1. / Ibs/Tons/yr 2. / lbs/fon/vr 3. / Ibsaonsm <br />4. I ibs/Tons/vr S. / lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: WHEN SAND AND GRAVEL SUPPLY IS DEPLETED <br />5.3 Anticipated end use of incidental commoditic(s) to be mined: N/A