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STATE OF COLORADO <br />DMSION OF RECLAMATION, MINING AND SAFETY <br />Deparonent ofNaMal <br />Resotirces <br />1313 Shermarl St, Room 215 <br />Denver, Colorado 80203 COLORADO <br />Phone (303) 8663567 CONSTRUCTION MATERIALS DIY 1 S I O N OF <br />RECLAMATION <br />FAX: (303) 832-8106 REGUILAR (112) OPERATION MINING <br />RECLAMATION PERMIT APPLICATION FORM SAFETY &. <br />Bill Ritter, Jr. <br />CHECK ONE ? - There is a File Number Already Assigned to this Operation Governor <br />P M - - (Please reference the file number currently assigned to this o do Hank D. Sherman <br />? P? Iq?,tive oire?r <br />New Application (Rule 1.4.5) _0 Amendment Application (Rule 1.10) Ronald W. carom <br />Conversion Application (Rule 1A 1) Division Di,ecw <br />Naft#W ReswmeTnatee <br />Permit # M (.provide for Amendments and Conversions of existing permits) <br />The application for a Constuction 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 63 (Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to include one (1) complete sieved and notarized ORIGINAL and one (1) copy of the completed <br />applicationfbim? two (2) copies of Exhibits A-S, Addendmn 1, appropriate sections of 6.5 (Geotech meal 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 older described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />AADlicant WMa.tor or comDanv name (name to be used on permit): Fiintstone 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): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />19.90 permitted acres <br />acres <br />19.90 acres <br />4. Fees: <br />4.1 New Application $2.696.00 application fee <br />4.2 New Quarry Application 2.00 <br />quarry application <br />4.4 Agent Fee $2.229.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) $2.696.00 conversion fee <br />5. Prim ary commoditie((s) to be alined: sand gravel <br />5.1 Incidental commoditie(s) to be mined: 1. lbs!Tom/vr 2. / lbs/Tons/vr <br /> 3. ! ibslTons/vr 4. lbs(fonalvr 5. / Iba/fons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: construction materials, backf ll materials <br />5.3 Anticipated end use of incidental commoditie(s) to be mined : <br />Office of Office of <br />Mined Land Reckon De wer • Grand Jur4lon • Durango Active and Inactive Mines