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TATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY ^ N O <br />Department of Natural Resources li <br />1313 Sherman St., Room 215 <br />CO <br />Denver, Colorado 80203 <br />VIS LOrori o? <br />Phone: t303t 866-3567 5 M ? ? CLAMATION <br />FAX: (303) 832 CONS'T'RUCTION MATERIALS (021 ? M I N I NG <br />Cfo REGULAR (112) OPERATION W n - &- <br />'3 m r`ti Cif go, SAFETY <br />RECLAILATION PERMIT APPLICATION FORM, w N <br />MAR 1 2009 tv 3 a o W. <br />Bill Ritter, Jr- <br />Of eClamat on' O g Governor <br />Re <br />and Safety#.here is a File Number Already Assigned to this Operation Harris 0. Sherman <br />cHct <br />Executive Director <br />Permit # M -_- (Please reference the file number currently assigned to this operati$Aald w. Catrany <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) D1V1S1on Director <br />Natural Resource Trustee <br />Conversion Application (Rule 1.11) <br />Permit # -.M .-J 9 (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 NOT be bound or in a 3-ring binder; maps should be folded to <br />8 112" 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 requested below. <br />1. Applicant/operator or company name (name to be used on permit): S/IC &/ts kc, a S,4 e,'0;1 G,1 e 5 f g In P <br />1.1 Type of organization (corporation, partnership, etc.): eo /'1 /'7 e f C? 6-r' &,q- -r- ZP> 0, 8 ;'S YO `!U <br />2. Operation name (pit, mine or site name): e Gtr S !'i <br />3. Permitted acreage (new or existing site): <br />02 s permitted acres <br />3.1 Change in acreage (-+-) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />acres <br />a S acres <br />4.1 New Application $2,696.00 application fee <br />4.2 New Quarry Application. $3,.342.04 quarry application <br />4.4 Amendment Fee 52,229.00.. amendment fee <br />4.5 Conversion. to 11.2 operation (set by statute) $2.696.00 - conversion fee <br />5. Primary, commoditie(s) to be rained: ..._-._c, rt... d' C7_/'a.?6 <br />5.1 Incidental commoditie(s) to be mined: I: _..,__,___, _,_ ,._„_,_-lbs(l'rms/vr 2. i_bs/'fonsiyr <br />3. ibs/Tons/ Ir 4. ------ '.____._..__...ibs%Tonsvr 5..__.._------../ lbs,Tons'yr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: CJ._____ ?o /1 5 L? d ?_!`.r <br />.__._.?____ <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />Office: of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mine.