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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 COLORADO <br />Denver, Colorado 80203 N o f <br />Phone: (303) 866-3567 TION <br />FAX: (303) 832-8106 G <br /> SAFETY <br /> <br />N MATERIALS <br />CONSTRUCTIO <br /> Bill Ritter, Jr. <br /> SPECIAL (111) OPERATION Governor <br /> Harris D. Sherman <br /> RECLAMATION PERMIT APPLICATION FORM Executive Director <br /> Ronald W. Cattany <br /> Division Director <br /> Natural Resource Trustee <br />The application for a Construction Materials Special 111 Operation Reclamation Permit contains fourmajor parts: (1) the application form; <br />(2) Exhibits A-L, Addendum 1, and any sections of Exhibit 6.5 (Geotechnical Stability Exhibit), as required by the Office, and outlined in <br />Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); (3) the application fee; (4) the Performance Warranty and if required a Financial Warranty. When <br />you submit your application, be sure to include one (1) completed signed and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A-L, Addendum 1, appropriate sections of Exhibit 6.5 (Geotechnical Stability Exhibit), as <br />required, a check for the application fee described under (4) below, and the fully executed Performance Warranty and Financial Warranty, if <br />required. Exhibits should NOT be bound or in 3-ring binders; maps should be folded to 8 2" X 11" or 8 2" X 14" size. To expedite <br />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 described below <br />I, Applicant/operator or companv name (name to be used on the permit): <br />Castle Rock Construction Company of C'ol nradn T r C <br />1.1 Type of organization (corporation, partnership, etc.): partnership <br />2. Operation name (pit mine or site name): VICK BORROW PIT <br />3. Permitted acreage: <br />4. New Application: <br />10 . 15 Permitted Acres <br />$898.00 Application Fee <br />5. Primarv commoditie(s) to be mined: earthwork <br />6. Name of owner to the surface of affected land: Anthony & Stacy 1-_ Vick <br />7. Name of owner to the subsurface rights of affected land: Anthony & Stacy Vick <br />8. Tvpe of mining operation: R7X Surface n Underground = In-situ <br />9. Location information: The center of the area where the majority of mining will occur: <br />COUN _L, <br />l [a <br />PRINCIPAL MERIDIAN (check one): X 6th (Colorado) 10th (New Mexico) Ute <br />SECTION (write number): S 33 <br />TOWNSHIP (write number and check direction): T 1 1 North South <br />RANGE (write number and check direction): R <br />East West __)4, QUARTER SECTION (check one): NE NW SE SW <br />QUARTER/QUARTER SECTION (check one): NE NW SE SW <br />GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the approximate elevation): <br />ninP miles 2013th of Huge Ge approx elev / 890 t <br />Office of Office of <br />Mined Land Reclamation Denver - Grand Junction • Durango Active and Inactive Mines