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STATE OF C01QKADC) <br />DIVISION Of REp.4MATION, MINING AND SAFETY <br />Dap "wd of NaWral Raaaoa <br />1313 Shemwi SL, Room 215 COLORADO <br />oanvw• cdOffiO mm CONSTRUCTION MATERIALS o t v t s t o N o r <br />t� 003) WM567 RECLAMATION <br />FAX 003) 832.8106 REGULAR (112) OPERATION MINING <br />RECLAMATION PERMIT APPLICATION FORM <br />an aam, l<. <br />M this Operation H w b of <br />There 1s a Fi <br />CHECK <br />�: � le Nwnber Already Assigned � p. shaffm <br />p - M . a (Please W&Mnce the file number currently asgpwd to dds opetatios)w" oed- <br />New Application (Rule 1.4.5) ,,,o Amendment Application (tale 1.10) aW w car <br />DM" MOO" <br />Conversion Application (Rule 1.11) NdLffA ere— Tnaaee <br />Permit # .�: 1977 223 - (pmvide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains tbree major parts: (1) the application <br />farm; (2) Exhibits A S, Addendum 1, any sections of Exhibit 6.5 (Gootechaicai Stability Exhibit; and (3) the application lication fee. When you <br />of the completed submit your application, be sure to include one (1) Mete 8100d and notarized - aced one (1) copy <br />application form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and acbech for <br />the application fee descrsbed under Section (4) below. Exhibits should NOT be bound or in a 3 -ring binder; naps should be folded to <br />81/2" X 11" or 81/2" X 14" size. To expedite processing, Please Provide the information in the format and order deecd'bed in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, l� sls information requested below. <br />1 . __..__at,___.r gr ..,.., ge (name M be used on oermic): JBS Five Rivers Cattle Feeding LLC <br />1.1 Type of organization (corporation, pa inctshipt eta): Limited Liab ilit — Company <br />2. Onceation game ni mine or aite>1a)~: Wiley Pit <br />3. r9mg d uram (new or exis8nn site): <br />3.1 Change in acreage H <br />3.2 Total acreage in Permit area <br />4. 1: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (sot by statute) <br />86.6 _ permitted acres <br />88.0 acres <br />174.6 yes <br />. SZAMA application fee <br />X42 quam application <br />S2,229-00- amendment fee <br />sumbe .. conversion fee <br />5. P -r t own a mmoaitic(a) to be�mbmd: Sand Gravel <br />.� <br />5.1 Incidental commodities) to be mined: 1. tbslTonaLvr 2. / <br />3. / ibe/Toma/vr 4. / ltm/fonahnr S. / lbs/ians/� <br />5.2 Anticipated end use of primary c ommoditic(s) to be mined: Construction materials to be used onsite and to be sold <br />53 Anticipated end use of incidental comnwditie(s) to be mined: <br />OIMoa of vmce ar <br />Mined land Ramon Denver • Grand jwX9w • Dura w Arrive and hucdve Mkw <br />