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DUR?+N <br />OFFPS <br />, <br />STATE OF NLD&ADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Depattnent of Natural Resources Q <br />13Denver Colorado R802oorn 21 S n <br />Phone: (303) 866-3567 n Cf T <br />FAX: (303)'632-8106 <br />/c? dQhL._ <br />COKSTAIICTIOK l(A2J9tI21L8 ray d '00/ - DEPAR't]ViE 4T OF <br />LIKITED IWACT oP8>iATIOH (110) NATUPAL <br />RFSO? <br />RECLAMATION PERMIT APPLICATION PORK Roy Romer <br />Governor <br />James S. lod+4W <br />Fxeaxive Dire= <br />Mid" S. Lwg <br />Division Director <br />CHECK ONS: _X_ New Application (Rule 1.4) AMUWWteat Application (C.R.S. 34-32.5-110) <br />conversion Application (Rule 1.11) <br />Permit (provide for Amendments and conversions of <br />existing permits) <br />The application for a Construction Materials Limited Impact Mining (110) Operation Reclamation <br />Permit contains three major parts: (1) the application form; (2) Exhibits A-J and Exhibit Z, <br />Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the <br />Office, and outlined in Rules 6.1, 6.2, 6.3, and 6.5; and (3) the Application fee. When you <br />submit your application, be sure to include one (1) complete 9JgZ_eA and notarized oo ORIa <br />and one (2) copy of the completed ivory application form, two (2) copies of Exhibits A-J and <br />Exhibit L, appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check <br />for the application fee described under (4) below. Exhibits should En be bound or in a 3-ring <br />binder; maps should be folded to 8 1/21* Y 11' or 8 1/2" % 14' size. To expedite processing, <br />please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORKRTION <br />Type or print clearly, in the space provided, all information described below. <br />wss--scss?-- ---s---a_s:?- <br />1. Awlicant/otlerator or comaanv name (name to be used on permitl: <br />_ Dave .Crites/ Crites Sand and V. - uml <br />1.1 Type of organization (corporation, partnership, etc.): pxnpri9tarshiT <br />1.2 I.R.S. Tax ID No. or Social Security Number: 84-1313627 <br />2. 02aration name (pit, mine or site name): Crites Sand and Gravel <br />3. omitted acreage (new or existing site): 9.75 permitted acres <br />3.1 Change in acreage (+ or -} acres <br />Total Acreage in Permit Area 9.75 acres <br />4. <br />4.1 New Application S875.00 application free <br />Amendment Fee.(C.R.S. 34-32.5-125(II)) 5575.00 application fee <br />4.2 Conversion Fee (from 130d to 110 87 .0 conversion fee (Rule 1.11.2(2)) <br />5. Primary commoditie(sl to be mined: _aravel Band <br />5.1 Incidental commoditie(s) to be mined: 1. 1,1s/Tons/yr <br />2. --- / 3 /Tons/vr 3. / lbs/Tone/vr <br />4. ! lbs/Tons/vr S. / _lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be minediPuilding pads/roads <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: