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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 80203 COLORADO <br />SI o w OO <br />Phone: (303) 866-356? RECLAMATION <br />FAX: (303) 832-8106 CONSTRUCTION MATERIALS MINING <br />REGULAR (112) OPERATION SAFETY <br />RECLAMATION PERMIT APPLICATION FORM <br />Bill Ritter. Jr. <br />Govemar <br />CHECK ONE: There is a File Number Already Assigned to this Operation Harris D. Shan <br />Executive Director <br />Permit 9 M -- - g 0 -2 2 4 (Piease reference the file number currently assigned to this operati da!d W. Carr y <br />New Application (Rule 1.4.5) x Amendment Application (Rule 1.10) Di"" Natural Resource Trustee <br />Conversion Application (Rule 1.11) <br />Permit # M - -$?.-2 A (provide for Amendments and Conversions of existing pemuts) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (h) 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 (Geotechmital 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 1,12" 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 />Agglicant/operator or company name (name to be used on Hermit): F r e m o n t P a y i n g ?i R e d i M i x, I n c. <br />1.1 Type of organization (corporation, partnership, etc.): corporation <br />2. Operation name (Hit, mine or site name): MacKenzie P i t <br />3. Permitted acreage (new or existing site): <br />3.1 Change in acreage (-1-) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Atreendment Fee <br />4.5 Conversion to 112 operation. (set by statute) <br />5. Primary commoditie(s) to be mined:_., nd_. <br />5.1 Incidental commoditie(s) to be mined: [. ?W _ - 1barIons%yr <br />3. ' lbsffongoT 4. Ibs/Tons/w <br />49. ;3 permitted acres <br />0 acres <br />acres <br />$206.00 application fee <br />$3342.00 quarry application <br />X2,-2.29.0© amendment fee <br />$) conversion fee <br />2. r lbs.,Tonsivr <br />1 11 s&gP ns/W <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Construction aggregate <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: N/A Office of Office of <br />Mined Land Reclamation Denver - Grand )unction - Durango Active and Inactive Mines