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STATE OF COLORADO <br /> NIV <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />• Department of Natural Resources <br />Room 215 <br />1313 Sherman St /? <br />{Y1 - a0 0- 051? <br />AUG 1 r, 2010 <br />COLORADO <br />., <br />Denver, Colorado 80203 <br />7 CONSTRUCTION MATERIALS <br />Di WWA Of R p r v t s t o N o s <br />CLAMATION <br />Phone: (303) 866-356 <br />FAX: (303) 832-8106 REGULAR (112) OPERATION se"M ailfA MINING <br /> RECLAMATION PERMIT APPLICATION FORM SAFETY <br /> Bill Ritter, Jr. <br /> <br />? I V.I. Number Already Assigned to this Operation Governor <br />CHECK ONE: There s a Harris D. Sherman <br />Pe M (Please reference the file number currently assigned to this operatioidecuuve Direcmr <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Ronald W. Calum <br />Division Dim= <br />Conversion Application (Rule 1.11) Natural Resource TmUee <br />Permit # _ Ivy- (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 the When you <br />submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of completed <br />application form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT 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. Applicant/overator or company name (name to be used on permit): Lafarge West, Inc. <br />1.1 Type of organization (corporation, partnership, etc.): corporation <br />2. Operation name (pit, mine or site name): Cerise Mine <br />3. Permitted acreage (new or existing site : <br />3.1 Change in acreage H <br />3.2 Total acreage in Permit area <br />65.48 permitted acres <br />0 acres <br />65.48 acres <br />4. Fees: <br />4.1 New Application $2,696.00 application fee <br />4.2 New Quarry Application $3342.00 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. Primary commoditie(s) to be mined: sand gravel fill <br />5.1 Incidental commoditie(s) to be mined: 1. gold - " an I lbs/Torrs/vr 2. / lbs/Tons/vr <br />3. ! lbs/Tons/vr 4. / lbs/Tons/vr 5. / Ibs/Tons/yr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: construction materials <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: N/A <br />Office of Office of <br />Mined Land Reclamation Denver • Grand junction • Durango Active and Inactive mines