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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 />Deriver, Colorado 80203 <br />Phan: (303) 866-3567 <br />FAX: (303) 8328106 <br />CONSTRUCTION MATERIALS <br />LIbIITED IMPACT (110) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: 11 There is a File Number Already Assigned to this Operation <br />ORADO <br />VISION O F <br />t OL N <br />CLAMATIO <br />MINING <br />SAFETY <br />BIN Rimer, Jr. <br />COMMON` <br />Hafts D. Sherman <br />Executive Director <br />Ronald W. C.attany <br />Division Director <br />Natural Resource Trustee <br />Permit # M (Please reference the fi-lemunber currently assigned to this operation) <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M - (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains thtee major parts: (1) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required <br />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 <br />sure to include one (1) colpiete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies <br />of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for <br />the application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 81/2"X <br />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 described below. <br />1. Applicant/operator or company name (name to be ul d on permit): _ Ov 1'12.5 n 4-5 ?L(G741On? <br />1.1 Type of organization (corporation, partnership, etc.): Robins Construction Company LLLP. <br />2. Operation name (pit. mine or site name): Robins Rock Pit <br />3. Permitted acreage (new or existing site): 9.7 permitted acres <br />3.1 Change in acreage (+) 0 acres <br />3.2 Total Acreage in Permit Area 9.7 acres <br />4. Fees: <br />4.1 New Application: $1,258.00 application fee <br />Amendment Fee (C.R.S. 34-32.5-125(11)): 00 application fee <br />4.2 Conversion Fee (from 110d to 110 2 6 0 conversion fee (Rule 1. 11.2(2)) <br />5. Primary commoditie(s) to be mmyined: (x,17 ?O G Z-? <br />5.1 Incidental commoditie(s) to be mined: 1. AMW Ibs/Tons/vr 2. _4/h lba2gg yr 3. Nf /? lbs/Tons/yr <br />4. N14 m:irrons/vr 5. LV/A lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined <br />Anticipated end use of incidental commoditie(s) to be mined: <br />Office of Office of <br />Mined Land Reclamation Deriver • Grand )unction • Durango Active and Inactive Minns