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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 50203 COLORADO <br />D I V I S I ON O F <br />Phone. (303) 566-3567 RECLAMATION <br />FAX: (303) 832-8106 CONSTRUCTION MATERIALS MINING <br />REGULAR (112) OPERATION -&- <br />RECLAMATION PERMIT APPLICATION FORM SAFETY <br />a D0 / - as q Go Ritter, In <br />Governor <br />CHECK ONE: There is a File Number Already Assigned to this Operation Harris D. Sherman <br />Executive Director <br />Permit # M - - -? (Please reference the file number currently assigned to this operaticpAaid w. Cattany <br />X New Application (Rule I A.5) Amendment Application (Rule 1.10) Division Director <br />Natural Resource Trustee <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 <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 corMleted <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 1 I" or 8 112" 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 />Oldcastle SW Group, Inc., dba Four Corners Materials <br />1. Applicantloyerator or company name (name to be used on permit): <br />1.1 Type of organization (corporation, partnership, etc.): corporation <br />2. Op eration name fait, mine or site name): Simmons Pit <br /> <br />3. Permitted acreage (new or existing site): 94.00 permitted acres <br />3.1 Change in acreage (+) acres <br />3.2 Total acreage in Permit area _ acres <br />4. Fees: <br />4.1 New Application HAP 2 42cog <br />$2&%.00 <br />application fee <br />4.2 New Quarry Application Division <br />of Reclamation $3.342.04 quarry application <br />4.4 . <br />Amendment Fee Mining and Safety $2 2 " amendment fee <br />4.5 Conversion to 112 operation (set by statute) $2,b96.lltt conversion fee <br />5. Primary commoditie(s) to be mined: Sand Gravel <br />5.1 Incidental commoditie(s) to be mined: 1. OVB-41, 000112 TO 2. Topsoil(. 5,35q <br />b ? <br /> 3. ' lbs/Tonsvr 4. 1 hbsfTons/vr 5. ! ibs/Tonsfvr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Asphalt, Road Base and Washed aggregate <br />5.3 Anticipated end use of incidental commoditie(s) to be mined Reclamation <br />Office of Office of <br />Mined Land Reclamation Denver • Grand function • Durango Active and Inactive Mines