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STATE OFCOLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman SL, Room 215 <br />Denver, Colorado 80203 C O L O R A D O <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS DIVISION OF <br />FAX: (303) 832-8106 REGULAR (112) OPERATION M IL ATGON <br />RECLAMATION PERMIT APPLICATION FORM SAFETY <br />Bill River, Jr. <br />CHECK ONE: 0 There is a File Number Already Assigned to this Operation Governor <br />peff M _ 96 _ 049 _ Ham: D. Shaman <br />_ _ (Please reference the file number currently assigned to this operatiO1)em sve Director <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Ronald W. Cavany <br />-0 Conversion Division Director <br />Application (Rule 1.11 ) Natural Reesowource Tntme <br />permit it M - 96 - 049 (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 (Geoteclumical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should LIOT 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. AyCheantloperator or company name (name to be used on permit): EVERIST MATERIALS, LLC <br />1.1 Type of organization (corporation, partnership, etc.): LIMITED LIABILITY CORPORATION <br />2. Operation name (pit, mine or site name): MARYLAND CREEK RANCH <br />3. Permitted acreage (new or existing site): 216 permitted acres <br />3.1 Change in acreage (+) acres <br />3.2 Total acreage in Permit area 216 acres <br />4. Fees: <br />4.1 New Application 696.00 application fee <br />4.2 New Quarry Application $3,342.00 quarry application <br />4.4 Amendment Fee $2,229-00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) $2,696.00 conversion fee <br />5. Primarv commoditie(s) to be mined: SAND GRAVEL <br />5.1 Incidental commoditie(s) to be mined: 1. Topsoil_ 1500 lbs/Tans/vr 2 _ ° e ° °d- / 2000 Ibs/Tons/yr <br /> 3. / lbs/Tons/vr 4. / ibs/Tons/vr 5. lbs/Tons/vr <br />5.2 Anticipated end use ofprimary commoditie(s) to be mined: CONSTRUCTION MATERIALS <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: Sale of Topsoil and Overburden