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. STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ?? ?y'ED <br />Department of Nawral Resources <br />1313 Sherman St., Room 21S <br />Denver, Colorado 80203 <br />Phone- (303) 866-3567 <br />FAX: (303) 832-8106 <br />AUG 19 2003 --" <br />DIVISION OF <br />MINERALS <br />GEOLOGY <br />RECLAMATION <br />MINING-SAFETY <br />Division at Minerals and GeoiM <br />FILE COPY CONSTRUCTIONMATERiAM <br />FOR SCANNIAMARIMC; PERMIT APPLICATION FORM <br />CHECK ONE There b a M Number Ahvady A alpted to thb Opera" <br />Permit # M 9 -AfL '! (Please refe mw tiw felt: mmbcroaarotiy umped to ibis operation) <br />X _ New Apples (Rule 1.4.E Amendment Application (Rule 1.10) <br />Conversion Application (Role 1.11) <br />Permit # M 4mvide for Alta and Converdoes of cwtbg pemtibb) <br />Bill Owens <br />Qwemor <br />Can E. WaMw <br />Executive Director <br />konaw W. Canty <br />Acting Division Director <br />The application fora CanstIaction Matmob Reprint 112 Operatioa Recla radon pemtit cam=s thbee majorparts: (1)&c gggicaftn form, <br />(2) Exhibits A-S, Addendmn 1, say sections oif l'ud&k 65 (Cleotech niod Stability EA t; and (3) the application fee. When you submityout <br />application, be sure 1o roulade one (1) gggpft siWd wAag err W WAW ORIGINAL, and one (1) copy of the co rnpleted ky application <br />form, two (2) copies of Exhibits AA Addendum 1, appropriate sections of 6.5 (Goofaohuical Stability Exbtbit, and a check for the application <br />fee dwatbod uooder Section (4) below Eah ibdo sboaM NOT be boarderis a 3-r* bonder, maps AbmU be (aided b 8 l2" X 1 l" of 8 12" <br />X 14" size. To mWedite prooea ia& pkmc provide the itdommsrtiw in the fambst and order dlisMJW is ibis farm. <br />ORAL OPERATION WFORMAI`ION <br />Type or print clearly, in the apace provided, MI information requested below. <br />I. Agenag /gREMor or comoanv napte (mere to be used ou permit): Baca County <br />1.1 Type of aegsmz Limn (oairpaeatioa, partnership, etc.): Goverment ExItity <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: 270033560 <br />2. Operationgabne fall- mine sift name): <br />3. Permitted ACME (new or egIft site): <br />3.1 Change in srcresp; (+) <br />3.2 Total acreage in Permit area <br />4. FM <br />Hinds Pit # 35 <br />permitted acres <br />sores <br />100 <br />acres <br />4.1 New Application 52.344.00 <br />application fee <br />4.2 New Quarry Application $2-906.00 quarry application <br />4.4 Amendment Fee 11.938.00 amendment foe <br />4.5 Conveaxion to 112 operation (set by su me) 52344.00 conversion fee <br />5. ltrim arv g ffljWod#tiefa) to be mined: CX,3re 1 S`,8nrl <br />5.1 Incidental coommooditic(s) to be mined: 1. - Ibs/T oas/vr 2. / Ib s/fons/vr <br /> 3. / /Taas/vr 4... / lao ns6x 5. / lb s/Tons/vr <br />5.2 Anticipated end use ofprimarycommoditie(s) to be mined. When supply id depleted. <br />5.3 Anticipated cod use of incidental mss) to be mined: N/ A