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M-xo/0 -?`t3 <br />STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 60203 <br />Phone: (303) 865.3567 <br />FAX: (303) 832-8106 <br />st- u ;i <br />2c 1,l <br />CONSTRUCTION MATERL40vision of Reclamarjcn, <br />LIMITED IMPACT (110) OPERATION i'1'''' 7a'3jy <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: <br />There Is a File Number Already Assigned to this Operation <br />t RADO <br />tON OP <br />MATION <br />NING <br />SAFETy <br />8111 Ritter, Jr. <br />Governor <br />Harris D. Sherman <br />Executive Director <br />Ronald W. catlany <br />Division Director <br />Nab" Resousce Trustee <br />Permit # M (Please reference the fikaumbercurrently assigned to this operation) <br />? New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11 <br />_ ) <br />Permit # M - - __ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required <br />by the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application foe. When you submit your application, be <br />sure to include one (1) complete simed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies <br />of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for <br />the application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1/21, X <br />11" or 8 W." X 14" size. To expedite processing, please provide the information in the format and order described in this fora. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, In the space provided, ALL information )described below. <br />1. AuRlicant/ouerator or comoanv name (name to be used on permit): Xt? 'PI-e, ?'ii f fir) ?+ <br />1.1 Type of organization (corporation, partnership, etc.): Joint Venture - partnership <br />2. Operation name (pit mine or site name): Falk/Ritchey's Redi Mix & Precast Inc Pit #1 <br />3. Permitted acrease (new or eldstins: site): _ permitted acres <br />3.1 Change in acreage (+) U? acres <br />3.2 Total Acreage in Permit Area 9.9 acres <br />4. Fees: <br />4.1 New Application: 1 L258.0? application fee <br /> Amendment Fee (C.R.S. 34-32.5-125(II)): 8$27.00 application fee <br />4.2 Conversion Fee (from 110d to 110 2$.696.00 conversion fee (Rule 1.11.142)) <br />5. Prim ary commoditie(s) to be mined: Gravel Clay Sand <br />5.1 Incidental commoditie(s) to be mined: 1. / lbs(rons/vr 2. lbs/Tons/vr 3. / lbsrrons/ <br /> <br /> 4. / Ibs/Tons/vr 5. / lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Manufacture of concrete <br />Anticipated end use of incidental commoditie(s) to be mined: Landscaping or road material <br />Office of Office of <br />Mined Nand Reclamation Denver - Grand lunction - Durango Active and Inactive Mines