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STATE OF <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St, Room 215 <br />Denier, Colorado 80203 <br />Phone: (303) 8663567 <br />FAX: (303) 832.8106 <br />C] <br /> <br /> <br />COLORADO <br />?AAL AN iQ ?vwF DIVISION Of <br />R QC C <br />1-? S' RECLAMATION <br />-P :'S"7? Co,St?,VcC' MINING <br />%?``? , ....... ?`?cr•? Q 5?t + c?' SAFETY <br />L CONSTRUCTION MATERIALS Bill River, )r, <br />LIMITED IMPACT (110) OPERATION Govemor <br />/V Harris D. Sherman <br />RECLAMATION PERMIT APPLICATION FORM Director <br />Ronald W. Catiany <br />Division Director <br />CHECK ONE: __ There is a File Number Already Assigned to this Operation Natrrral Resource Trustee <br />Permit # M -1990134 (Please reference the qjLqurnber currently assigned to this operation) <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />_ Conversion Application (Rule 1.11) <br />Permit # M - 1990 - 134 (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-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical 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)(b); and (3) the application fee. 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 form, two (2) copies <br />of Exhibits A -J, Exhibit L, 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 81/2" X <br />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 described below. <br />1. <br />James H Ross & Kathleen H Ross <br />2. Operation name fpit, mine or site name): Ross pit <br />3. Permitted acreage (new or existing site): 5.66 S= to (? permitted acres <br />3.1 Change in acreage (+) 3.84 acres <br />3.2 Total Acreage in Permit Area 9.50 acres <br />4. Fees: 9.50 <br />4.1 New Application: $1J58.00 application fee <br />Amendment Fee (C.R.S. 34-32.5-125(11)): 827.00 application fee <br />4.2 Conversion Fee (from 110d to 110 $2,696.00 conversion fee (Rule 1. 11.2(2)) <br />5. Primary commoditie(s) to be mined: sand & gravel fill dirt <br />5.1 Incidental commoditie(s) to be mined: 1. Soon / m^s lbs/Tondw 2. 1000/ Ions lbs/Tons/vr 3. / lbsfTons/vr <br />4. / lbs/Tons/vr 5. / Ibs/T'ons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: <br />Anticipated end use of incidental commoditie(s) to be mined: <br />AApplicant/ooerator or company name (name to be used on permit): <br />1.1 Type of organization (corporation, partnership, etc.): <br />Office of Office of <br />Mined Land Reclamation Deaver • Grand Junction + Durango Active and Inactive Mines