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TATE (IP COLORADO <br />DIVISION Of MINERALS AND GEOLOGY <br />iN.11ar(ntent of Nd(ural Resources <br />1 I 13 Sherman Si., Room 215 <br />I)vnvvr, Colorado 80203 <br />I'hone• i M 11 86h.3567 <br />FAX: ( 1().11 832-8106 <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />Rov Romer <br />Governor <br />lames S. Lochhead <br />Executive 0tector <br />Michael B. Long <br />Division Director <br />CEECK ONE: New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />._ Conversion Application (Rule 1.11) <br />Permit # M - 93 - 088 - (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 submit your <br />application. be sure to include one (1) complete signed and notarized IVORY 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 />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />---------------- <br />1. Applicant/operator or company name (name to be used on permit): <br />BACA COUNTY ROAD 6 BRIDGE DISTRICT #1 <br />1.1 Type of organization (corporation, partnership, etc.): COUNTY <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: 84-6000744 <br />2. operation name (pit, mine or site name): GUNKEL PIT NO. 31 <br />3. Permitted acreage (new or existing site): 9.025 permitted acres <br />3.1 Change in acreage (+) 150,975 _ acres <br />3.2 Total acreage in Permit area 100,000 acres <br />4. Fees: <br />4.1 New Application _SI,875.00 application fee <br />4.2 New Quarry Application 52,325.00 _ quarry application <br />4.3 Milling Application (Non-DMO) $3,100.00 milling application <br />4.4 Amendment Fee 51,_550.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) _ 51,875.00 conversion fee <br />5. Primary commoditief s) to be mined: GRAVEL <br />5.1 Incidental commoditie(s) to be mined: 1. lbs/Tons/v= <br />5.2 <br />5.3 <br />2. 1 lbs/Tons/ r 3. / lbs/Tons/vr <br />4. / lbs/Tons/vr 5. 1 lbs/Tons/vr <br />Ancicipated end use of primary commoditie(s) to be mined: UNTIL PERMITTED ACRES <br />Anticipated end use of incidental commoditie(s) to be mined: DEPLETED <br />I