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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St_, Room 215 C O 1 O R A D O <br />Denver, Colorado 80203 D i r i S i o N o r <br />Phone: X303) 866-3547 RECLAMATION <br />FAX: 13031832-8106 MINING <br />SAFETY <br />CONSTRUCTION MATERIALS <br />Bill Rater. Jr. <br />LIMITED IMPACT (110) OPERATION Gov rncr <br />Harris D. Shea ;an <br />RECLAMATION PERIIIT APPLICATION FORM Execut:ve Director <br />Ronald W. Cananv <br />Division Direcxu <br />CEIECK ONE: 'T'here is a File Number Already Assigned to this Operation katuralRt-wurceTrustee <br />Permit ". 4i - - (Please reference the file number currently assigned to this operation) <br />X New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit ## M (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required <br />by the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be <br />sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies <br />of Exhibits A-1, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for <br />the application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 112" X <br />11" or 8 112" X 14" size. To expedite processing, please provide the information in the tbrmat and order described in this form. <br /> GENERAL OPERATION iNFORj ATION <br />'T'ype or print clearly, in the space provided, ALL information described below. <br />1. Ap plicant/operator or company name (name to be used on permit): _Colorado Quarry I, LLC <br /> I.1 Type of organi7ation (corporation, partnership, etc.): LLC <br />2. Op eration name (Lilt, mine or site name,): Meadow Hollow Quan <br />3. Permitted acreage (nett or existing site): permitted acres <br /> 3.1 Change in acreage (f) 9.990 acres <br /> 3.2 Total Acreage in Permit Area acres <br />4. Fees: <br /> 4.1 New Application: SI.258.00 application fee <br /> Anlcrrdntent Fee (C_R.S. 34-32.5-12501)): S827.00 application fee <br /> 4.2 Conversion Fee (front 110d to 110 51,25$.00 conversion tee (Rule 1.112(2)) <br />5. Primarv commoditie(s) to be mitred: Sandstone <br /> 5.1 incidental conrntoditic(s) to be mined: 1. Ebs "Fattsr'vr 2. Ibs "I onsjyr 3. 1 ?,_ Ib Totlsr` r <br /> 4. lbs'Tons/y 5. _ ??,,,_Ibs? Fonsyr <br /> 5.2 Anticipated en(1 use of priinaryconrmoditie(s) to he mined: December 31, 2107 <br /> Anticipated end use of incidental commoditie(s) to be mined: __ ,._______.. __.......__ ._._ _ _ _.._.__. .... ..... ___ <br />Office t,f <br />\hinr l Land Reclamation <br />Denver • Grand Junction • Durango <br />Office of <br />Active and Inactive Shines <br />