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<br />i <br />HATE OF COLORADO <br />DIVISION OF MINERALS AND CEOLOGY <br />Department of Natural Resources <br />ces <br />1313 Sherman St., Room 215 D I v t S ION O F <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS MINERAL 5 <br />FAX: 1303) 832-8106 REGULAR (112) OPERATION & <br />GEOLOGY <br />RECLAMATION PERMTT APPLICATION FORM r•. R E C L A M A T I O N <br />MINING-SAFETY <br />RECEIVE <br />MAY 18 2001 Bill Owens <br />CHECK ONE: There is a File Number Already Assigned to this Operation GoveGregrnor <br />rn Walther <br />as a?d Gttl7?gyve Director <br />Permit # M - 77. 484 (Please reference the file number currently assi0ive do ion f o erpera ton <br />gn tits o <br />Michael B. Long <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) D-vision Director <br />% Conversion Application (Rule 1.11) <br />Permit # M - (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application form: <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotecbnical Stability Exhibit. and (3) the application fee. When you submit your <br />application, be sure to include one (1) comp ete si ed and notarized IVORY ORIGIlVAL and four (4) copies of the completed No <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 11" or 8 1/2" 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 information described below. <br />1. Applicant/operator or company name (name to be sed on permit <br />BACA COUNTY <br />1.1 Type of organization (corporation, partnership, etc.): GOVERNMENTAL ENTITY <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: 84-6000744 <br />2. Oper ation name (ph, mine or site name): GRAVEL PIT NO. 7 <br />3. Permitted acreage (new or existing site): 1.7 permitted acres <br /> 3.1 Change in acreage (+) 158.3 _ acres <br /> 3.2 Total acreage in Permit area 160- acres <br />4. Fees: <br /> 4.1 New Application 52.344.00 application fee <br /> 4.2 New Quarry Application $2.906.00 quarry application <br /> 4.4 Amendment Fee $1.938.00 amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) $2.344.00 conversion fee <br />5. Prim arv commoditie(s) to be mined: GRAVEL SAND <br /> 5.1 Incidental commoditie(s) to be mined: 1. Ibsaons/vr 2. / lbslfoqg/vr 3. ! lbslfonsfvr <br /> 4. / lbs/fons/vr 5. / lbsrrons/vr <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 <br />