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t "r,4aoZ <br />7' STATE OF COLORADO <br />DIVISION OF RKLAMATION, MINING AND SAFETY <br />Department of Natural Resoures <br />1313 Sherman St., Room 215 C O L O R A D O <br />D w r o w , C o b r i d o 80203 CONSTRUCTION MATERIALS D I V I S I O N o r <br />Phone: (303) 8663567 RECLAMATION <br />FAX: (303) 832-8106 REGULAR (112) OPERATION MINING <br />RECLAMATION PERMIT APPLICATION FORM SAFETY <br />Bill RiM, Jr. Governor <br />CHECK ONE: El There is a File Number Already Assigned to this Operation <br />Harris D. Shaman <br />p M (Please reference the file number currently assigned to this operatioa)cww Dir.aor <br />New Application (Rule 1.4.5) -1? Amendment Application (Rule 1.10) Ro pig <br />Conversion Application (Rule 1.11) Natural Resource Tmmn <br />Permit # M - 2000 158 (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 forth, 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 />I. Information requested below. <br />JL_ <br />Type or print clearly, in the space provided, <br />1. Appgcant/onerstor or company name (name to be used on permit): Platte Sand and Gravel, LLC <br />1.1 Type of organization (corporation, partnership, etc.): Limited Liability Company <br />2. Op eration name (pit, mine or site name): S & H Mine <br />3. Per mitted acreare (new or existing site): 1,239.40 permitted acres <br />3.1 Change in acreage (+) = I <br />?'? 269.23 acres <br /> <br />3.2 - <br />Total acreage in Permit area <br />1,508.63 <br />acres <br /> <br />4.: <br />4.1 <br />4.2 New Application <br />New Quarry Application My Ian of Reclamation, 52.646.00 <br />$3,342.00 application fee <br />quarry application <br />4.4 Amendment Fee &Rafety $2229.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) $2.646.00 conversion fee <br />5. Pri mary commoditie(s) to be fined: sand gravel <br />5.1 Incidental commoditie(s) to be mined: 1. lbs/Tons/vr 2. / lbs/Tons/w <br /> 3. / Ibs/Tous/vr 4. / lbs/Tons/vr 5. / lbs/Toris/ys <br />5.2 Anticipated end use of primary commoditie(s) to be mined: construction materials <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br /> office Of <br />Mined land Reclamation Denier • Grand lurictian • Durango Active and Inactive Mina