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STATE OF COLORADO <br />DIVISION OF REaAMATION, MINING AND SAFETY P W <br />Department of Natural Resources b-%6 <br />1313 Sherman 5L, Room 215 1 rRECLAMAT03N <br />L O P D O <br />Denver, Colorado 8020 `' CONSTRUCTION MATERIALS DIVISION r S t O N f <br />Phone (303) 866 35 IFAX- (303) 632-8106 ®'009 REGULAR (112) OPERATION SD MINING <br />??" 2 ?gG?,l?4AMATION PERMIT APPLICATION FORM SAFETY <br />o?a???IV NOV 19 2009 ?.,.. <br />y .l <br />CHECK ONE: E] . There is a File Number Already Assigned to this Operation Mining ^? and d a Safety <br />e <br />[lams D. Sherman <br />P M - - (Please reference the file number currently assigned to this operatiox)ectmve Director <br />?-• i New Application (Rule 1.4.5) ? Amendment Application (Rule 1.10) Ronald W. cya'n' <br />171 Division Director <br />Conversion Application (Rule 1.11) Natural Resource Trustee <br />Permit # M - - - (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 (Geotechnica) 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 81/2" 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, information requested below. <br />1. APplicant/operator or comganv name (name to be used on Permit): Flintstone Gravel & Trucking, Inc. <br /> 1.1 Type of organization (corporation, partnership, etc.): Corporation <br />2. Operation name (Pit, mine or site name): Pickering Family Pit <br />3. Permitted acreage (new or existing site): 19.90 permitted acres <br /> 3.1 Change in acreage (+) acres <br /> 3.2 Total acreage in Permit area 19.90 acres <br />4. Fees: <br /> 4.1 New Application $2.696.00 application fee <br /> 4.2 New Quarry Application $3342.00 quarry application <br /> 4.4 Amendment Fee $2,229.00 amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) $2,696.00 conversion fee <br />5. Primary commoditie(s) to be mined: sand gravel <br /> 5.1 Incidental commoditie(s) to be mined: 1. - Ibs/Tons/vr 2. / lbs/Tons/vr <br /> 3. / lbs/Tons/vr 4. / 1bsJTons/vr 5. / lbs/Tons/vr <br /> 5.2 Anticipated end use of primary commoditie(s) to be mined: construction materials, backfill materials <br /> 5.3 Anticipated end use of incidents) commoditie(s) to be mined: <br /> Office of <br />1 <br />Office of <br />Minted land Reclamation <br />Denver • Gland junction • <br />Durango Active and Inactive mines