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k /v- '?" ewe) l - ree- <br />STATE OF QOLO&ADO <br />DIVISION OF RECLAMATION, MINING AND SAFM <br />Department of Natural Resources ? ? l <br />1313 Sherman St., Room 215 7 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS COLORADO <br />FAX. (303) 832-8106 n t v t s t o N 01F <br />REGULAR (112) OPERATION RECLAMATION <br />RECLAMATION PERMIT APPLICATION FORM MI &NG <br />SAFETY <br />There Is a File Number Ahead Bill Ritter, Jr. <br />Y Assigned to this Operation Governor <br />p M _ Q.saa _ 'Y;T <br />.. D' Shannon <br />(Please reference the file number currently assigned to this operatio Haft <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Roneid w. miry <br />Conversion Application (Rule I A 1) Division Diream <br />Natural Resourw Trustee <br />permit # M - 26927++3 - 3 <br />(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 <br />submit your application, be sure to include one 1 co and application fee. When you <br />application fo () , () n' fete s'gned andnotaii?d ORIGINAL and one 1 c <br />ml, two 2 copies ofExhibits A-S Addendum 1 sections of 6.5 () Exhibit, of the completed <br />the application fee described under Section (4) below. Exbibits Shoould NOT be bound o rm a 3-iing 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 formation in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, In the space provided, ALL information reouested hpu... <br />1. AuoIIc Lotonerator or nanv Hemp inure to be used on newt): 120th Estates Partners <br />1.1 Type of organization (corporation, partnership, etc.): LLP <br />2. Opera 'on name (att. mine or site name): 120th Estates <br />3. Permitted acres a (new or cm no dte); <br />3.1 Change in acreage (+) <br />3.2 Total acreage in permit area R <br />4. 4 New Application OCT <br />I ?d9 <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />?__??,,,,; ,•- - ?, r r ,. . <br />4.5 ComVemion to 112 operation (set by statute) <br />5. Prriina_rv commoditie(s) to be mined: <br />5.1 Incidental commoditie(s) to be mined: <br />3 / <br />1 gravel _ 400K Ibs/T.onsl <br />41.3 <br /> permitted acres <br />0 <br /> acres <br />41.3 <br /> acres <br />2 696.00 application fee <br />$3 2.00 quarry application <br />2 29.0 amendment fee <br />2 96.00 conversion fee <br />2,229.00 <br />2. / 1 ons/vr <br />lbs/ I ons/ 4. / Ibs?Tons/vr <br />5.2 Anticipated end use of 5' / Ibs?Tons/vr <br />Primary commoditie(s) to be mined: Concrete and Asphalt <br />5.3 Anticipated end use of incidental commoditie(s) to be mined:Fill <br />Office of <br />Mined Land Reclamation ) <br />Denver • Grandleme*ion • Durango Office of <br />. <br />Active and Inactive Mines