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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 C O[ S R. A. D O <br />otvtsto!v or <br />Phone: (303) 866-356' RECLAMATION <br />FAX: (303) 832-8106 CONSTRUC'T'ION MATERIALS M.I N I NG <br />REGULAR (112) OPERATION -&- <br />SAFETY <br />RECLAMATION PERMIT APPLICATION FORA <br />Bill Ritter, tr- <br />Governor <br />CHECK ONE: There is a :File Number Already Assigned to this Operation Harris O. Sherman <br />Executive Director <br />Permit ## M - - (Please reference the file number currently assigned to this operati%Ld W. cattany <br />New Application. (Rule 1.4.5) Amendment Application (Rule 1.10) Division Director <br />Natural Resource Trustee <br />--Conversion Application (Rule 1.11) <br />Permit # M ?-P& (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 I, 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. StabilityExhibit, 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 />'T'ype or print clearly, in the space provided, A.Lt, information requested below. <br />yL?i?,y, <br />Applicant/operator or company name (name to be used on permit): G'9iJGG??T? G'er()?w <br />1.1 Type of organization (corporation, partnership, etc.): <br />2. Operation name (pit, mine or site name): <br />3. :Permitted acreage (new or existing site): ?fD 2S permitted acres <br />3.1 Change in acreage (3') U? acres <br />3.2 Total acreage in Permit area .__--acres <br />4. Fees: <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 x+2,224.00 amendment tee <br />4.5 Conversion. to 11.2 Operation (set by statute) $2,096.00 conversion fee <br />5. Primary cotmrtoditie(s) to be mined: ---•- l-v?AyEL <br /> <br />53 D - 1FR <br />I.ncitlental comnrctditie(s) to be mined: I..,-, araEal- 740P lbs-`" ansfyr <br />2...-__-•-----___ _._..---------- <br />---lbs;'rons/yr <br /> 3. Ibs'rrons/yr 4.lhs °Tons=yr 5. ---------•----... `--------------- - ]hs'tbn lyr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: -_-..-.. .._.-._.._ <br />5.3 Anticipated end use of incidental. commoditie(s) to be mined: ----------------- ------_-__-, --------.------.---____-. <br />Office of Office of <br />Mined Land Reclamation Denver • Grand )unction - Durango Active and Inactive Mines