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?1- boo/-OAS <br />STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY t?>???"' <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />D e n v e r , C o l o r a d o 80203 COLORADO <br />Phone: 4303) 866-3567 CONSTRUCTION MATERIALS D I V 1 S 1 0 N o F <br />RECLAMATION <br />FAX: (303) 832 8106 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 />Pe> M - r1°'` (Please reference the file number currently assigned to this operatio=)ecwve Director <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Ronald W. Catmny <br />Division Director <br />TE Conversion Application (Rule 1.11) Natural Resource Trustee <br />Permit # M -200.2--+3'P 3 (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 (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 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 />Type or print clearly, in the space provided, ALL information requested below. <br />1. Ap plicant/operator or company name (name to be used on permit): 120th Estates Partners <br /> 1.1 Type of organization (corporation, partnership, etc.): LLP <br />2. Op eration name (nit, mine or site name): 120th Estates <br />3. Permitted acreage (new or existing site): 41.3 permitted acres <br /> 3.1 Change in acreage (+) ?,>r. -- <br />_ 0 acres <br /> 3.2 ,... <br />Total acreage in Permit area <br />j 41.3 acres <br /> <br />4. Fees: <br /> 4.1 New Application $2,696.00 application fee <br /> <br />4.2 sris:. <br />New Quarry Application ? <br />R GV <br />4 $3342.00 <br />quarry application <br /> 4.4 !?? <br />Amendment Fee O $2,229.00 amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) $2,696.Ofl conversion fee <br />5. Pri warv commoditie(s) to be mined: 2,229.00 <br /> 5.1 Incidental commoditie(s) to be mined: I. gravel 400K lbs/Tons/vr 2. lbs/Tons/vr <br />3. / lbs/Tonslvr 4. / lbs/Tons/vr 5. / lbv Tons/vr <br />5.2 Anticipated end use of primary cottmroditie(s) to be mined: Concrete and Asphalt <br />5.3 Anticipated end use of incidental commoditie(s) to be mined:Fill <br />Office of Office of <br />Mined Land Reclamation Denver • Grand junction • Durango Active and Inactive Mines