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/rI - aao9- 0/0 <br />STATE OF COLORADO <br />Dlvlsm OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherrnan St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 856-3567 <br />FAX: (303) 832-6106 <br />JAN 2 22009 <br />Otvlsinfo?ln of Reclamatlorl <br />CONSTRUCTION MATERIIALV and Safety <br />COLORADO <br />D IV Is I ON O r <br />RECLAMATION <br />MINING <br />SAFETY <br />Bill Ritter, Jr. <br />LIMITED IMPACT (110) OPERATION Governor <br />Harris D. Sherman <br />RECLAMATION PERMIT APPLICATION FORM Executive Director <br />Ronald W. Cattany <br />Division Director <br />CHECK ONE: There is a File Number Already Assigned to this Operation Natural Resource Trustee <br />Pennit # M - (Please reference the file number currently assigned to this operation) <br />is 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-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibits 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 1/2" X <br />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. Awlicant/operator or company name (name to be used on permit): c a '? '?R r o o r 11+r t; c La ? Pa i-,, r o : LL C <br />1.1 Type of organization (corporation, partnership, etc.): 1..,, i ? e r1 ?-,r eT h ? ? , {? C gu r n c: < C-i s 0,- <br />2. Operation name (pit, mine or site name): 1 ?-("-: n -T- I T 1L <br />3. Permitted acreage (new or ezistine site): <br />3.1 Change in acreage (+) <br />3.2 Total Acreage in Permit Area <br />4. FM: <br />4.1 New Application: <br />Amendment Fee (C_R.S. 34-32,5-125(il)): <br />permitted acres <br />acres <br />_ acres <br />1,01) application fee <br />$#27.00 application fee <br />4.2 Conversion Fee (from 110d to 110 $1,258.00 conversion fee (Rule 1.1 I.2(2)) <br />5. Primary commoditie(s) to be mined: ^i O ?aR l^? V2 c s 0 ??S4 i CJi 2 r } J i? F L` <br />5.I Incidental commoditie(s) lobe mined: l.Qre r Ibs/Tons/yr 2.i Lei 15cc.7 lbs/Tonslvr 3. L_ acs //rc lbs/Tons/wr <br />Ibs/Tons/ 5. 111 _1n / c -C,: IbslTonslYr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: <br />f /? t <br />Anticipated end use of incidental commnoditic(s) to be mined: <br />Office of Office of <br />)`lined Land Reclamation Denver - Grand Junction - Durango Active and inactive Mines