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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />1313 Sherman St., Room 2A" ?' `?f ?? Vkr- .9 1, Denver, Colorado 80203 <br />3567 <br />FAX: (303) 832-8106 CONSTRUCTION MATERIALS <br />REGLII..AR (112) OPERATION <br />D?? M OW .19 and ?1:CI,AMATION PERMIT APPLICATION FOR ?t <br />r„ <br />Department Phone. (303) of 866 Natural Resources <br />COLOR.A.DO <br />D IV IS I ON OF <br />RECLAMATION <br />MINING <br />SAFETY <br />Bill Ritter, Jr. <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 operatiTgald w. Cattany <br />New Application. (Rule 1.4.5) 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 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 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 INFORMA'riON <br />• Type or print clearly, in the space provided, ALL information requested below. <br />I. Applicant/operator or comnanv name (name to be used on permit): GG tiS-TrZ.?GT/OtV <br />1.1 Type of organization (corporation, partnership, etc.): '_ C- rz <br />2. Operation name (pit, mine or site name): 32. r; E:L t?IT- <br />3. Permitted acreage (new or existing site): permitted acres <br />3.1 Change in acreage { +) acres <br />3.2 Total acreage in Permit area _ Z 5 __•__ acres <br />4. Fees: <br />4.1 <br />New Application <br />$2,696.00 <br />application tee <br />4.2 New Quarry Application. $3,342.00 quarry application <br />4.4 Amendment Fee $2,229,00 amendment tee <br />4.5 (conversion. to 112 operation (set by statute) $2,696.00 conversion fee <br />5. Primary commoditie(s) to be mined: .._3.?ll i> _ -yam '.?=? -----._-----•------. ___.--.-........--------- <br />5.1 Incidental commod:itie(s) to be mined: i. _.Wf?._._.,._..._...........__lbsfonsirr 2..__. ......._..---_.._' ..................._.. _._tbs:l=v_ns% <br /> lbslTons/yr 4, t lbsi Ions/w 5. <br />---------- - --- -------------- - <br />-------------- -- l.bsi`Ibns;yr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: GD!?%,5-__ `- G ! 0 m !? FT??? t °4 t-- 5 <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br /> <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Ac Aive tend Inactive Mines <br />o0Q - G)05