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ST <br />COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY , <br />Department of Natural Resources JAN 3 0 2009 <br />1313 Sherman St., Room 215 C O L O . <br />Denver, Colorado 80203 Diu Won of Reclamafion <br />Phone: (303) 866-3567 I IN and Safety Y 'R <br />FAX: (303) 832-8106 CONS'T'RUCTION MATE [? MINING <br />REGULAR (112) OPERATION ? AN ? F9 <br />RECLAMATION PERNMIT APPLICATION FORM GRAND jUNefleN E <br />8iiP111MQN OF <br />" i RECIAWZ*NrMINING & SAFETY <br />CHECK ONE: _ XX There is a File Number Already Assigned to this Operation Harris D. Sherman <br />- Executive Director <br />Permit M _?_0a__ (Please reference the file number currently assigned to this operati(VaAd W, Q tiany <br />New Application Rule 1.4.5) XX Amendment Application (Rule 1.10) Division Director <br />( Natural Resource Trustee <br />Conversion Application (Rule 1.11) <br />8 0 8 N-0 <br />Permit # 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 <br />form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to include one (1) coMplete signed and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) 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 NO `T' 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, 44L information requested below. <br />Apolicantloperator or company name (name to be used on permit): <br />1.1 Type of organization (corporation, partnership, etc.): Local <br />2. Overation_nanne (pit, mine or site name); Smith Pit No. 20 <br />Permitted a reage (new or existing site): <br />3 42.62 permitted acres <br />. +26.48 <br />3.1 Change in acreage N acres <br />3.2 Total acreage in Permit area 69. 10 _ w acres <br />4. Fees: <br />4.1 <br />New Application <br />$2,b46.00 <br />application tee <br />4.2 New Quarry Application $3,342.00 quarry application <br />4.4 Amendment Fee XXX 2 2$9.gp amendment fee <br />4.5 Conversion. to 112 operation (set by statute) $24696.00._. conversion fee <br />5. Primary contmoditie(s) to be mitred: Sand Gravel Clay _ <br />5.1 Incidental. comnxoditie(s) to be mined: 1. _ _ N?A lbs;°1or/5n 2. lbs/Ton?IYC <br />lbslTons/yr 4. ( lbst?onsjyr 5. - i lbsf'f ns//vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined:. Road Construction Materials <br />5.3 Anticipated end use of incidental cornmoditie(s) to be mined: N/A - - <br />Office of Office of <br />Mined I-and Reclamation Denver Grand junction • Durango Active and Inactive Mines <br />offa Coun'j3oard o <br />ounty Commissioners <br />Government