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STATE OF COLOF ADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 COLORADO <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS DIVISION OF <br />RECLAMATION <br />FAX: (303) 832-8196 REGULAR (112) OPERATION MINING <br />RECLAMATION PERMIT APPLICATION FORM SAFETY <br />Bill Ritter, Jr. <br />CHECK ONE: Q? There is a File Number Already Assigned to this Operation Governor <br />2,002 014 Harris D. Sherman <br />Pe 40 <br />rmi. M -_- (Please reference the file number currently assigned to this operatio>a)ecoeve Director <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Ronald W. Cattany <br />f Division Director <br />Conversion Application (Rule 1;11) Natural Resource Trustee <br />Permit # M - 2002_014 _ (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 (Geotechnieal 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 />S 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 />1. Applicant/operator or company name (name to be used on Permit): Robins Construction, LLLP <br />1.1 Type of organization (corporation, partnership, etc.): Limited Liability Limited Partnership <br />2. Operation name (Pit, mine or site name): Robins Pit No. 1 <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 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. <br />Primarv commoditie(s) to be mined: Gravel <br />9'84 permitted acres <br />8.692 acres <br />18.532 acres <br />$2,696.00 application fee <br />$342.00 quarry application <br />$2,229.00 amendment fee <br />$2,696.00 conversion fee <br />5.1 Incidental commoditie(s) to be mined: I. N/A N/A lbs/Tons/vr 2. / lbs/Tons/vr <br />3. / lbs/Tons/yr 4. / lbs/Tons/yr 5. I lbs/Tonsivr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Road Construction Material <br />5.3 Anticipated end use of incidental commoditie(s) to be mined.N/A <br />Office of Office of <br />Mined Land Reclamation Denver • Grand )unction • Durango Active and Inactive Mines