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STATE OF COLORADO <br />DIVISION OF RECIAMIITION, MINING AND SAFETY <br />Department of Natuml Resources <br />1313 Sherman St., Room 215 <br />O O <br />L 0 <br />Dw.w, Cobrado 80203 <br />CONSTRUCTION MATERIALS o I 'V <br />o N <br />Phone: (303) 866.3567 RECLAMATION <br />FAX, 4303) 8328106 REGULAR (112) OPERATION MINING <br />RECLAMATION PERMIT APPLICATION FORM SAFETY <br />CHECK ONE [ X ] There is a File Number Already Assigned to this Operation Bill Ritter, It. <br />Crovemor <br />Harrts D. shor w <br />Permit # M - 1998 - 022 (Please reference the file number currently assigned to this operation) Executive Dire w <br />Romid w. ca u" <br />Divksion Dimcw <br />[ ] New Application (Rule 1.4.5) [ ] Amendment Application (Rule 1.1 "P. M1C`Mtb <br />[ X ] Conversion Application (Rule 1.11) SEP 0 2 2009 <br />GRAND JUNCTION FIELD OFFICE <br />Permit # M - 1998 - 022 (provide for Amendments and Conversions of existing permits) DIVISION OF <br />RECLAMATION MINING & SAFETY <br />This application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application <br />for; (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 <br />for the application fee described under section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 <br />V2 x 11" or 8 V2 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. Applicant/operator or company name (Name to be used on permit): The Gallegos Comoration <br />1.1 Type of organization (corporation, partnership, etc.) Corporation <br />2. Operation name (pit, mine or site name): Conger Harvesting Area <br />3. Permitted acreage (new or existing site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 <br />4.2 <br />4.3 <br />4.4 <br />5. Primary commodities(s) to be mined: Moss/Surface Rock <br />5.2 <br />5.3 <br />5.1 Incidental commoditie(s) to be mined: 1. N/A - lbs/Tons/vr <br />3. - lbs/Tons/yr 4. - lbs/Tons/yr 5. <br />Anticipated end use of primary commoditie(s) to be mined: -Architectural Stone <br />Anticipated end use of incidental commoditie(s) to be mined: N/A <br />7.56 permitted acres <br />23.33 acres <br />30.89 acres <br />$2,696.00 application fee <br />$3,342.00 quarry application <br />$2,229.00 amendment fee <br />$2,696.00 conversion fee <br />2. - lbs/Tons/yr <br />lbs/Tons/ <br />Office of Office of <br />Mined Lind Reclamation Dever * Grand )unction ? Durango Active and Inactive Mines