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, 44 2oo9- <br />STATE OF COLOMDO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St, Room 215 C O o t <br />Denver, Colorado 80203 D t v Phone: (303) 8663567 CONSTRUCTION MATERIALS REC <br />FAX: (303) 832 -8106 REGULAR (112) OPERATION MINING <br />RECLAMATION PERMIT APPLICATION FORM SAFETY <br />Bill Ritter, Jr. <br />� Governor <br />CHECK ONE I L <br />IIII—� There is a File Number Already Assigned to this Operation <br />Hams D. Sherman <br />p M (Please reference the file number currently assigned to this operatioa)ec„ Live Director <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Ronald W. catta"y <br />Division Director <br />D 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 (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 11" or 8 1/2" 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. Ayolicant/operator or company name (name to be used on permit) Asphalt Constructors, Inc. <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />2. Operation name (pit, mine or site name) Alamosa Pit <br />3. Permitted acreage (new or existinz site) <br />89 permitted acres <br />3.1 <br />Change in acreage N <br />acres <br />3.2 <br />Total acreage in Permit area <br />89.38 acres <br />4. Fees: <br />4.1 New Application <br />$2,696.00 application fee <br />4.2 <br />New Quarry Application <br />$3,342.00 quarry application <br />4.4 <br />Amendment Fee <br />$2,229.00 amendment fee <br />4.5 <br />Conversion to 112 operation (set by statute) <br />$2_ 69 6.00 conversion fee <br />5. Primary c ommodities to be mined: Sand <br />5.1 <br />Incidental commoditie(s) to be mined: 1. none _ lbs/Tons/vr <br />2. / lbs/Tons/vr <br />3. / lbs/Tons/vr 4. / lbs/Tons/vr <br />5. / lbs/Tons/yr <br />5.2 <br />Anticipated end use of primary commoditie(s) to be mined: Concrete & asphalt aggregates & earthwork,fill operations <br />5.3 <br />Anticipated end use of incidental commoditie(s) to be mined: n/a <br />DEC 212009 <br />Division of Reclamation, <br />Mining and Safety <br />Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango <br />Office of <br />Active and Inactive Mines <br />