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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY RIltCEIVED <br />Department of Natural Resources <br />1313 Sherman St., Room 215 OCT 2010 COLORADO <br />Denver, Colorado 80203 CONSTRUCTION MATERIALS n t v i s t o rt o Phone: (303)8663567 Division of Keciamatio RECLAMATION <br />FAX: (303) 832-8106 REGULAR (112) OPERATION Mining and Safety MINING <br />RECLAMATION PERMIT APPLICATION FORM SAFETY <br />Bill Ritter, Jr. <br />CHECK ONE: ?? There is a File Number Already Assigned to this Operation Govemor <br />19 77 317 Harris D. Sherman <br />P M - 19 _ (Please reference the file number currently assigned to this operatioa)eartive Director <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Ronald W. cattany <br />Division Director <br />? Conversion Application (Rule 1.11) Natural Resource Trustee <br />Permit # M -19 - 77_- 317 (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 fee. When you <br />submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the 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; snaps 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/oyerator or company name (name to be used on permit): SUMMIT BRICK & TILE CO. <br />1.1 Type of organization (corporation, partnership, etc.): CORPORATION <br />2. Operation name (pit, mine or site name): CEDARWOOD CLAY MINE <br />3. Permitted acreaee (new or existine site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: CLAY GRAVEL CRUSHED <br />5.1 Incidental commoditie(s) to be mined: 1. - lbs/Tons/vr <br />9.90 permitted acres <br />83.35 acres <br />93.25 acres <br />$2,696.00 application fee <br />$3,342.00 quarry application <br />$2,229.00 amendment fee <br />?$ . 6.00 , conversion fee , <br />STONE MATERIAL <br />2. ! lbs/Tons/vr <br />3. / lbs/Tons/vr 4. / lbs/Tons/vr 5. / lbs/Tons/yr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: BRICK MANUFACTURING & CONSTRUCTION AGGREGATES <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />Office of Office of <br />Mined Lind Reclamation r Denver • Grand junction • Durango Active and Inactive Mines