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VIA, <br />STATE OF COLORADO <br />DIVISION OF RECIAMATION, MINING AND SAFETY <br />Department of Naairal Resomces <br />1313 Sherman SL, Room 213 <br />Denver, Colorado 60203 <br />Phone (303) 866,3367 <br />FA%; (303) 032.8106 <br />R'.12EIED <br />CT 13 2010 <br />GivisiGn of Reclamation, <br />CONSTRUCTION MATERIALS <br />LIMITED IMPACT (110) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />C HECK ONE: a There Is s wile :Number Already Assigned to this Operation <br />COLORADO <br />DIVISION Of <br />RECLAMATION <br />MINING <br />SAFETY <br />8111 Rlnwr Jr. <br />Governor <br />Harris D. Sherman <br />ExKsAlve Dkecwr <br />Ronald W. Calbny <br />Drvisiori Dinklor <br />NaUnI ltmaww Truman <br />Permit # M - - •_ (Please reference the dumber currently assigned to this operation) <br />New Application (Rule I A.5) ff_.JI Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <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-I, Exhibit L, Addendum 1. any sectionsof Exhibit 6.5 and Geotochnical 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 Xb); and (3) the application foe. When you submit your application, be <br />sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed application faun,, two (2) copiers <br />of Exhibits A-1. Exhibit I., 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 81 e2" X <br />11" or 8 1d2" X l4" 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 described below. -? <br />1. Applicantloperator or company name (name to be used on permit): TIMOTHY D. WILLIAMS & BETTY J. WILLIAMS <br />1.1 Type of organization (corporation, partnership, etc.). PARTNERSHIP <br />2. Operation name (pit, mine or site name): WILLIAMS PIT No. 1 <br />3. Permitted acreage (new or existing site). 9.85 permitted acres <br />3.i Change in acreage (+) oars <br />3.2 Total Acreage in Permit Area 9.85 acres <br />4. E: <br />4.1 New Application. 51.258.00 application fee <br />Amendment Fee (C.R.S. 34-32.5-125(11)): 5827.00 application fee <br />4.2 Conversion Fee (from 110d to 110 52.696.00 conversion fee (Rule 1.11,2(2)) <br />5. Primary commoditie(s) to be mined: CONSTRUCTION FILL ROAD BASE <br />5.1 incidental commoditie(s) to be rained: 1. lba,"lonsivr 2. - lbsgo 3. Ibsi Tops, yr <br />4. Ihs'TM&'vr 5. IbL"fonv`vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: ROAD BASE FOR CORDOVA WIND FARM <br />Anticipated end use of incidental commoditie(s) to be mined: <br />Office of office of <br />Mined (.and Reclamation Demrer • Grand lunation • Durango Active and inaelwe Mines