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<br /> <br />HATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1113 Sherman St., Room 215 O r v r S t O N O f <br />Denver. Colorado 80203 <br />Phone: (303) 866.3567 CONSTRUCTION MATERIALS MINERAL 5 <br />FAX: 1303) 832-8106 REGULAR (112) OPERATION G E O LOG Y <br />RECLAMATION PERMIT APPLICATION FORM RECEIVE M EN I N H SAFETY <br />°MAY 18 2001 Bill Owens <br />CHECK ONE: There is a File Number Already Assigned to tbls Operation <br />Divl ion ( Miners s a d G Greg E. Watcher <br />Permit # 1?- 77-_A86 _ (Please reference the file number currently assign e? to t?is opera?ton? <br />Michael B. Long <br />New Applikation (Rule 1.4.5) Amendment Application (Rule 1.10) Division Director <br />K Conversion Application (Rule 1.11) <br />Peru ut # -lam- - (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 1) 2 Operation Reclamation Permit contains three major parts: (1) the application form: <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechuical Stability Exhibit: and (3) the application fee. When you submit your <br />application, be sure to include one (1) SMIete sigged 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 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 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 loformation described below. <br />1. Applicant/operator or company name (name to be awed on permit <br />BACA COUNTY <br />1.1 Type of organization (corporation, partnership, etc.). COVERNMENTAL ENTITY <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: 84-6000744 <br />2. Op?r gtion name (nit. mine o[Mite name): GRAVEL PIT NO. 7 <br /> <br />3. Perm itted acreage (new or existing site): 1.7 permitted acres <br /> 3.1 Change in scresge (+) 158.3 acres <br /> 3.2 Total acreage in Permit area -160- acres <br />4. Fees: <br /> 4.1 New Application 12,344.00 application fee <br /> 4.1 New Quarry Application 12,906-00 Quarry applicstiou <br /> 4.4 Amendment Fee A.:M00 amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) 52.344.00 conversion fee <br />5. Pdm arv commoditie(s) to be mined: GRAVEL SAND <br /> 5.1 Incidental commoditie(s) to be mined: 1. / Ibsrronslvr 2. / Ibs/roq?/vr 3. / lbs/Tons/vr <br /> 4. / lbs/Ibns/vr S. / 1bs/Tous/v_r <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 commoditie(s) to be mined: N/A