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TATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />DEPARTMENT O <br />NATURAI <br />RESOURCE <br />Roy Romer <br />Governor <br />James S. Lochhead <br />Executive Director <br />Michael 8. Long <br />Division Director <br />CHECK ONE: New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />X Conversion Application (Rule 1.11) <br />Permit # M - 84 _ 101 - (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 Ivory 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 />1. Applicant /operator or company name (name to be used on permit) : <br />Downare Land, Cattle & Equipment Company <br />1.1 Type of organization (corporation, partnership, etc.) : Partnershi1) <br />1.2 I.R.S. Tax I.D. No. or Social, Security Number: 523-84-1191 <br />2. Operation name (pit, mine or site name) : Chaparral Meadows Pit <br />.3. Permitted acreage (new or existing site) : 9.7 permitted acres <br />3.1 Change in acreage (+ or -) 57.1± acres <br />3.2 Total acreage in Permit area 66.8± acres <br />4. Fees <br />4.1 New Application S1,875.00 application fee <br />4.2 New Quarry Application $2,325.00 quarry application <br />4.3 Milling Application (Non-DMO) $3,100.00 milling application <br />4.4 Amendment Fee $1, 550.00 amendment fee <br />4-5 Conversion to 112 operation (set by statute) $1,875.00 conversion fee <br />.5. Primary commoditie(s) to be mined: Sand and Gravel <br />5-1 Incidental commoditie(s) to be mined: 1. - lbs/Tons/vr <br />2. / lbs/Tons/vr 3. / lbs/Tons/vr <br />4. / lbs/Tons/yr 5. / lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie (s) to be mined: Road Base, Asphalt, Concrt <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: