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0 <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resomm <br />1313 Sherman SL, Room 215 <br />Denw Colorado 80203 <br />m-aota- <br />Phone: (303) 8663567 CONSTRUCTION MA17MAT S <br />FAX: (303) 832-8106 REGULAR (112) OPERATION <br />RE(3 AMATION PERMTF APPLICATION FORM <br />COLORADO <br />DIVISION OF <br />RECI AMATION <br />MINING <br />SAFETY <br />Bill Ritter,lr. <br />CHECK QNE ? There Is a File Number Already Assigned to this Operation Governor <br />Hart D.9wom <br />Pe It vet _ (Please reference the file number currently assigned to this operatioa)em otrecl- <br />New Application (Rule I A.5) Amendment Application (Rule 1.10) R-W W- C-"r <br />El Conversion Application (Rule 1.11) Nataxid Rescu eTnoos <br />Permit # M - (provide for Amendments and Converslons of existing pernrils) <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 Exlubit 6.5 (Geotechnical StabilityExhlbit; and (3) the application fee. When you <br />submit your application, be atll+e 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 (Geoteclu ical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should X% be bound or in a 3-ring binder, maps should be folded to <br />81/2" X i l" or 81/2" 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. AMPlicant/oaerator or company name (name to be used on Permit): R10 Blanco County <br />1.1 Type of organization (corporation, partnership, etc.): Govemment <br />2. Operation name (olh mine gate WW: Spring Creek Gravel Pit <br />3. Permitted acreage (new or existing sib: <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Eeer <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Comrersion to 112 operation (set by statute) <br />5. <br />Primary commodifie to fi be mined: gravel <br />5.1 Incidental commoditie(s) to be mined: 1. - lbsrronstvr <br />3. / lbslTonslvr 4. / ibs/fons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Road Base <br />5.3 Anticipated end use of incidental commoditie(s) to be mimed: <br />(D <br />STATE OF COLORADO <br />18.88 permitted acres <br />acres <br />}2,696.00 application fee <br />.4aaftr9* quarry application <br />:MOM amendment fee <br />.... 3AVoN conversion fee <br />2. / lbs/Pons/vr <br />5. / lbs/1' jb% <br />Office of Office of <br />Mined land Reclamation Denver - Grand )unction - Dwww Active and Inactive Mines