2010-12-14_PERMIT FILE - M2010071

• Permit No: M2010071
• IBM Index Class Name: PERMIT FILE
• Doc Date: 12/14/2010
• Doc Name: Registered w/ Boulder County Clerk & recorder
• From: City of Lafayette
• To: DRMS
• Email Name: MAC
• Media Type: D
• Archive: No

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DEC 141010
STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY p r Q ?/
Department of Natural Resources I?1 O?
1313 Sherrnan St, Room 215
Denver, Colorado 80203 CONSTRUCTION MATERIALS
Phone: [phone]
FAX: [phone] REGULAR (112) OPERATION
RECLAMATION PERMIT APPLICATION FORM
COLORADO
DIVISION OF
RECLAMATION
MINING
SAFETY
CHECK ONE: ? There Is a File Number Already Assigned to this Operation
Bill Kilter, Jr.
Governor
Harris D. Sherman
P M (Please reference the file number currently assigned to this operation)eweive Director
New Application (Rule 1.4.5) _ Amendment Application (Rule 1.10) Ronald W. caltany
Division Director
Conversion Application (Rule 1.11) Natural Resource Trustee
Permit # M - - - (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application
form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you
submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed
application form, two (2) copies of Exhibits A S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for
the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to
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.
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, ALL information requested below.
1. Auplicaut/overator or company name (name to be used on permit): City of Lafayette
1.1 Type of organization (corporation, partnership, etc.): Municipal Government
2. operation name (pit mine or site name): Goose Haven Reservoir #2 - Complex Expansion
3. Permitted acreage (new or eldsting site):
3.1 Change in acreage (+)
3.2 Total acreage in Permit area
110.0 peed acres
acres
110.0 acres
4. Fees:
4.1 New Application $2.696.00 application fee
4.2 New Quarry Application $3,342.00 quarry application
4.4 Amendment Fee $2,229.00 amendment fee
4.5 Conversion to 112 operation (set by statute) X2,696.00 conversion fee
5. Primary commoditie(s) to be mined: Swd and Gravel
5.1 Incidental commoditie(s) to be mined: 1. Fill _ W'?"ON 1 lbs/Tons/vr 2. E T"p I Not K" n lbs/Tons/yr
3. / lbs/Tons/vr 4. ! lbslTons/vr 5. / lbs/Tons/w
5.2 Anticipated end use of primary commoditie(s) to be mined: Construction Aggregate
5.3 Anticipated end use of incidental commoditie(s) to be mined: Construction, Landscaping
RE+GMED
DEC 14 2010
DMil ion of IZ tcxr.
Office of Office of
Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines