2009-09-25_PERMIT FILE - M2009077

• Permit No: M2009077
• IBM Index Class Name: PERMIT FILE
• Doc Date: 9/25/2009
• Doc Name: New 110c Appl
• From: Tracey and Ed Grimes
• To: DRMS
• Media Type: D
• Archive: No

/yl-r o j- ® 77
STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources
1313 Sherman St., Room 215 C O L O R A D O
Denver, Colorado 80203 R1. ( D t v t s t 0 N o e
RECLAMATION
Phone: [phone] ' FF ,r,
FAX: [phone] M 1. N I N G
s?? 2009 SAFETY
CONSTRUCTION MATERIALNIt"i3 O9 "Y'
Mi inirg Wtd Safe -V lain Ritter, Jr.
LIMITEI) IMPACT (110) OPERATION Governor
Harris D, Sherman
RECLAMATION PERMIT APPLICA'T'ION FORM Executive Director
Ronald W. Catiany
Division Director
C.IIECK ONE: There is a File Number Already Assigned to this Operation Natural Resource Trustee.
Permit # M = __- _ (Please reference the file number currently assigned to this operation)
X_ New Application (Rule 1.4.5) Amendment Application (Rule 1.10)
__-___-- Conversion Application (Rule 1.11)
Permit #/ M (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the
application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required
by the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be
sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies
of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for
the application fee described tinder (4) below. Exhibits should NOT be bound or in a 3-ring binder.; maps should be folded to 8 1/2" X
1 l" or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form.
GENERAL, OPERATION INFORMA'T'ION
Type or print clearly, in the space provided, A.I.I, information described below.
I. Applicant/operator or company name (name to be used on permit): Tv-dc,"--4-4. Ed G riy_K8c_
I.1 Type of organization (corporation, partnership, etc.):?_,.._ -------
2. Operation name (pit, thine or site name): _ ^-------.-
3. Permitted acreage (new or existing sitel: permitted acres
3.1 Change in acreage (+) acres
3.2 Total Acreage in Permit Area acres
4. Fees:
4.1 New Application:
1 2`6 58.()
application fee
Amendment. Fee (C.R.S. 34-32,5-125(il)): $$27.00 application fee
4,2 Conversion. Fee (from 110d to 110 l J58.o0 conversion fee. (Rule I .11.2(2))
5. Prlmary commoditie(s) to be nuned: 5-ahd_.__ Gave _..........__-_--
5.1 Incidental conunoditic(s) to be ruined: 1. kk .... ...... {bs/..Lq is/yr 2. ......... _../.... _......... 1hs/'1"ors/yr 3....._.
4• _._.._..?_.._._._lb tts/}r 5. lhslLTons/.yr /( rl_
5.2 Anticipated end use of primary cotntriodit.ie(s) to be mined:
Anticipated end use of incidental commoditie(s) to be mined: ------
_...__.._......_...__...__..._._.._._------_._,_,._____......_ .__._.._.-_..._.___..___...._._-...__...._._..._._...__
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Office of Office of
Mined Land Reclamation Deriver • Grand ]unction - Durango Active and Inactive. felines