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<br />SCAN.N.0 <br /> <br /> <br />STATE OF, <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources JUL 2 4 2009 <br />1313 Sherman St.. Room 2iS <br />Deriver, Colorado 80203 DiV14 N Of Reciam t0 L 0 RA D 0 <br />1 S I O N O F <br />Phonm (303) 866.3567 Mitring and Safe DIVISION Y <br />CONSTRUCTION MATERIALS RECLAMATION <br />FAX: 1303) 632-8706 M 1 N I NG <br />-&- <br />REGULAR (112) OPERATION SA & Y <br />RECLAMATION PE&MIT APPLICATION FORM <br />Bill IGtter. If. <br />Gmn.or <br />CHECK ONE: X There is a File Number Already Assigned to this Operation Harris D. Sherman <br />fmagive Dimdor <br />Permit # 11+ -? 9 - 9 7 -0 2 7 (Please reference the file number currently assigned to this operati?? w. Caumy <br />New Application. (Rule t.4.5) Amendment Application (Rule 1.10) osvisl°n Of <br />Natural Resource rnrstee <br />X Conversion Application (Rule 1.11) <br />Permit # M - 9--_L9 _ 02 7 (provide for Amendments and Conversions ofeiisting 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 applicatioa fee. When you <br />submit your application, be sure to include one (1) complete signed and notgrized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies ofBxlubits A-S, Addendum 1, appropriate sections of6.5 (GeotecbnicalStabUityExhibit, and acheck 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 81/2" 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. AopUcant/ooerator or company name (name to be used on permit): A.J. Bott i Construction and Gravel <br />1.1 Type of organization (corporation, partnership, etc.): Company <br />2. Operation name (pit, mine or site name): Moonscape Pit <br />3. Permitted acreage (new or existing site): <br />3.1 Change in acreage (-I-) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />7.57 permitted acres <br />14.08 acres <br />21.65 <br />acres <br />4.1 New Application $2,696.00 application tee <br />4.2 New Quarry Application $3,342.00 quarry application <br />4.4 Amendment Fee 52.229.00 amendment fine <br />4.5 Conversion to t l2 opeaatioa (set by smiths) $2.6%-A conversion fee <br />5. Primary co Rtoditids) to be mind:. Sand Gravel <br />5.1 Incidental commoditie(s) to be mined: 1. Topso:zll, oool 0 2.OVB 1 2, OOgb ©vr <br />3. ! IbsMons/Yr 4. l f) cltts?+r S. __ _ _ i 16sITo?rJy_r <br />5.2 Anticipated end use of primary cornmodirie(s) to be mined: Roadbase _ .? <br />5.3 Anticipated end use of incidental coin moditie(s) to be mined: Reclamation <br />Office of OHiae ai <br />Mined Land Reclamation Denver • Grandlunction • Durango Active and Inactive Mines