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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY t/ i )t(N- 01 <br />Department of MakoW Resmmes <br />1313 Sherman St., Room 215 ? Denver, Coloado 10203 <br />NOV 06 2009 C O L O RAD <br />O <br />VISI O <br />Phone: (301) 8663567 D I O Nt F <br />RECLAMATION <br />FAX: (303) 832-8106 CONSTRUCTION MATERIALS Div"n of Reciaftldoll, MINING <br />REGULAR (112) OPERATION Mning and Safety -- &- <br />RECLAMATION PERMIT APPLICATION FORM SAFETY <br />silt WtW, Jr. <br />Govemor <br />CHECK ONE: X There Is a File Number Already Assigned to this Operation Kwis D. Sheman <br />FYeudive Director <br />Permit 5r! _M - 6 -061-_,_,,, (Please reference the file number currently assigned to this operate ld w. C mny <br />New Application (Rule 1.4.5) X Amendment Application (Rule 1.10) D mm' <br />Tnatee <br />Conversion Application (Rule 1.11) <br />Permit # M -? 86- 161 - (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) c owlete signed and notarized ORIGINAL and one (1) copy of the completed <br />application forms 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 I V or 8 112" 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 />Oldcastle SW Group, Inc. dba Four Corners Materials <br />1. Amu cantimemlor or com»anv name (name to be used on permit): <br />1.1 Type of organization (corporation, partnership, etc): Corporation <br />2. Oneradon name (nit, nine or site name); Cugnini Pit <br />3. Permitted sereafre (new or wAstina site): 99.18 permitted acres <br />3.1 Change in acreage (+) 23.11 acres <br />3.2 Total acreage in Permit area <br />122.29 acres <br />r . , <br />4. EW: <br />4.1 New Application $2,696.110 application fee <br />4.2 New Quarry Application 0_ quarry application <br />4.4 Amendment Fee 52,2x9,80 amendment fee <br />4.5 Conversion to 112 operation (set by statute) SZA696.00 conversion fee <br />5. Primary commoditle(s) to be mined: Sand Gravel <br />5.1 Incidental conwxxhtie(s) to be mined: hverburden- 300, 000 lbs/Ions/vr 2 Topsoil /7,500 <br />lbsllonstvr <br />3. ! Ibsmoas/vr 4. I ) ons/vr 5. I hbsCl ons/yl <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Road Base, Asphalt and other construction materials <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: Reclamation <br />Office of Office of <br />Mined Land Reclamation Daiwa - Grand )unction • Durango Active and tnaatve Mina