2009-12-18_PERMIT FILE - M2009093

• Permit No: M2009093
• IBM Index Class Name: PERMIT FILE
• Doc Date: 12/18/2009
• Doc Name: New 110c Appl.
• From: James Theisen
• To: DRMS
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY
Dqm trnetu of Natural Res WAMS
1313 9wasan Sit., Room 215
ILA D O
t M
Denver, Colorado SO=
Phone: (M) g� �7
t O N o e
ATION
FAX: [phone]
NING
SAFETY
DEC CONSTRUCTION MATERIALS
Bill RNW,Jr.
1,Il41 I)BIPACT(110)OPERATION
Governor
Hams D. Sherman
'` nine - "` !,:) ��RECLAMATION PERMIT APPLICATION FORM
Exemd" Director
permitted acres
RomW W. Cate M
3.1 Change in acreage ( +)
Division Director
CHECK ONE F] There is a File Number Already Assigned to this Operation
Natural Resource TnWae
Permit # M - - -_ (Please reference the fikAumber currently assigned
to this operation)
New Application (Rule 1.43) Amendment Application
(Rule 1.10)
Conversion Application (Rule 1.11)
Permit # M - - - (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the
application form; (2) Exhibits A -J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechuical Stability Exhibit, as required
by the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.62(1)(b); and (3) the application fee. When you submit your application, be
sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies
of Exhibits A -J, Exhibit L, Addendum 1, and appropriate sections of 6.5 ( Geotechuical Stability Exhibit), as required, and a check for
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
11" or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form.
GENERAL OPERATION INFORMATION
T or print clearly, In the space provided, ALL Inform describe below.
1.
ADDlicantloverator or company name (name to be used on permit) a&
1.1 Type of organization (corporation, partnership, etc.):
2.
Operation name (pit, mine or site name) CAT L--
3.
Permitted acreage (new or existine site)
/0
permitted acres
3.1 Change in acreage ( +)
acres
3.2 Total Acreage in Permit Area
acres
4.
Fees
4.1 New Appli cation:
S 1 ,258.00
application fee
Amendment Fee (C.R.S. 34- 32.5- 125(In):
$827.00
application fee
4.2 Conversion Fee (from 110d to 110 2S ,696.00 conversion fee (Rule 1.11.2(2))
A
5.
Primary commodities) to be mined
5.1 Incidental commodities) to be mined: 1. / lbs/Tons/vr 2. /
lbs/TomJvr 3. /
lbslTons/vr
4. / Ibs/ Tons/vr 5. /
lbs/T nsj +Lr
5.2 Anticipated end use of primary commodities) to be mined: �r
Anticipated end use of incidental commodities) to be mined:
office of
Mined Land Redamation Denver • Grand Junction • DarAW
Office of
Active and inactive Mines