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STATE OF COLORADO <br />DIVISION OF RE(2.AWTION, MINING AND SAFETY <br />Deparanent of Nazural Resources iV, p??Qq - l dlo <br />1313 Sherman SL, Room 213 <br />Denver, Colorado 80203 COLORADO <br />Phone: (303)8663567 CONSTRUCTION MATERIALS D i v r s r o N Of <br />PAX: (303) 832-8106 REGULAR (112) OPERATION RECLAMATION <br />MINING <br />RECLAMATION PERAUT APPLICATION FORM SAFETY <br />819 Ritter, Jr. <br />CHECK ONE ? - There Is a File Number Already Assigned to this Operation oOVe`"Or <br />Harris D. Shen can <br />Pet M - - _ (Please reference the file number currently assigned to this operation <br />)wmv a Dirac r <br />New Application (Rule 1.4.5) -0 Amendment Application (Rule 1.10) Ronaid W. Camugr <br />Conversion Application (Rule I i 1) Dk4sio" Ofte cw <br />Natural ResourceTnstee <br />Permit # M - - - (provide for Amendments and Conversions of existing permits), <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contams three major parts: (1) the application <br />form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechuical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be we to include one (1) ccamolete signed and notarized ORIGINAL and one (1) copy of the completed <br />appiicationfonn, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhtbit, and acheck for <br />the application fee described under Section (4) below Exhibits should NOT be bound or in a 3-nng 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, ALL information requested below- <br />1 . App eantloperator or company name (name to be used on permit)- Flintstone Gravel & Trucking, Inc. <br />1.1 Type of organization (corporation, partnership, etc.): COrporatbon <br />2. Op eration name (pit, mine or site namek Pickering Family Pit <br />3. Per mitted 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 flee <br />4.2 New Quarry Application $3,342.00 quarry application <br />4.4 Amendment Fee $2=9.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) $2.696.00 conversion fee <br />5. Prim arv commoditie(s) to be mined: sand ' gravel <br />5.1 Incidental commoditie(s) to be mined: 1. ibsfrons/vr 2. / lbsfrons/vr <br /> 3. ! lb&Mnstw 4. / IlaTons/vr 5. 1 Iba(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 incidental commoditie(s) to be mined: <br />Office of <br />Mitred lard Redamation ? Denver • Grand lundion • Durango Office of <br />Active and inactilve Mines