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DIVISION Of RECLAMATION, MINING AND SAFETY STATE OF COLORADO <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 RECEIV O <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS Of <br />FAX: (303) 832-8106 REGULAR (112) OPERATION RECLAMATION PERMIT APPLICATION FORM 'UN 0 5 2Division of Reclam <br />177- <br />(• Jr. <br />CHECK ONE: ® There is s File Number Already Assigned to this Operation Mining and Saf <br />P M - - - Harris D. shem%an <br />(Please reference the file number currently assigned to this operatioa)ec,mve Director <br />T_XT New Application (Rule 1.4.5) Amendment Application (Rule 1.10 Ronald W. Canany <br />Conversion Application (Rule 1.11) ) Division Dhnxtor <br />Natural Resource Trustee <br />Permit # M - 2003- 024 _ (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 INFORMATION <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): pit t 1 1 i?Q C <br />---- ?unt3t <br />1.1 Type of organization (corporation, partnership, etc.): Government <br />2. Op eration name (pit mine or site name): Ward Pit <br />3. Permitted acreage (new or existing site): <br /> 9-9 permitted acres <br />3.1 Change in acreage (+) <br /> <br />3.2 <br />Total acreage in Permit area 9 - 9 <br />19 <br />8 acres <br /> . acres <br />4. Fees: <br />4.1 New Application <br /> <br />4.2 <br />New Quarry Application 2 696.00 <br />application fee <br />4.4 Amendment Fee 53.342.00 quarry application <br />4.5 Conversion to 112 operation (set by statute) amendment fee <br /> 26%.00 conversion fee <br />5. Primarv commoditie(s) to be mined: Gravel -sand <br />5.1 Incidental commoditie(s) to be mined: 1. - Ibs/Tons/vr 2. / lbs/Tons/vr <br /> 3. ! Ibs/Tons/vr 4. / Ibs/Tons/vr 5. / lbs/Tolls/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Road gravel and base material <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: NIA <br />Office of <br />Mined Land Reclamation Deliver - Grand junction - Durat OffDurango Active and Inactive Mines