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lllYlUlNll?tl k, STATE (t-COLOMDO <br />DIVISION OF MINERALS AND GEOLOGY <br />Oulhutmcnl 4 Kitural Resources <br />1113 Sherman St.. Room 215 <br />Deriver. Ct>anracto 80203 <br />11horte: t NI;) 8b6-3S67 <br />FAX: t !0.;1831.8106 <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORD! <br />DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />Roy Romer <br />Governor <br />lames S. Lochhead <br />Executive Oirector <br />Michael B. Long <br />Oiviseon Oirecrix <br />CHECK ONE: New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />X Conversion Application (Rule 1.11) <br />Permic N _(_-2_- 087 - (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 submic your <br />application. be sure to include one (1) complete si ned and rota ized IVORT ORIGINAL and four (4) <br />copies of the completed Ivor 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 />-_? -----,30 ------.-- ---- ------? ??-----------7.----7--.. - ---? 377-5 ?O7--J-3 -07-...----7`30..-700 ?. - 07 7 <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />...-?---..----=--7------7--..-..'1-?=--X30---------.?-.---..----?----1..---- <br />1. ARplicant/overator or company name (name to be used on Rermit): <br />BACA COUNTY ROAD & BRIDGE DISTRICT #1 <br />1.1 Type of organizacion (corporation, partnership, etc.): COUNTY ROAD & BRIDGE <br />1.2 I.R.S. Tax I_D. No. or Social Security Number: 84-6000744 <br />2. Operation name (nit, mine or site name): WEEDEN LAND A CATTLE CO. PIT NO. 30 <br />3. Permitted acreage (new or existing site): 9.9 permitted acres <br />3.1 Change in acreage (+) 150.1 acres <br />3.2 Total acreage in Permit area 160.0 acres <br />4. Fees: <br />4.1 New Application 51,875.00 application fee <br />4.2 New Quarry Application S2.325.00 quarry application <br />4.3 Milling Application (Non-DMO) S3.100.00 milling application <br />4.4 Amendment Fee 51.550.00 amendment wee <br />4.5 Conversion to 112 operation (set by stacute) $1.875.00 conversion fee <br />5. Primar y commoditie(s) to be mined: GRAVEL <br />5.1 Incidental commoditie(s) to be mined: 1. - Lbs/Tons/v= <br /> 2. % Lbs/Tons/vr 3. / lbs/Tons/vr <br /> 4. i lbs/Tons/vr 5. lb7 /Tons/vr <br />5.2 Anticipaced end use of primary commoditie(s) to be mined: UNTIL GRAVEL IS DEPLETED <br />5.3 Anticipated end use o' incidental commoditie(s) to be mined: