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B2 <br />M- 'Z o / 12 - 0 <br />STATE Or COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 60203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />RE4Vt) <br />D;21 20it <br />CONSTRUCTION MATE 1'on of ReclaMptjppr <br />vufptl? <br />LIMITED IMPACT (110) OPERATION / & <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: ? There Is a File Number Already Assigned to this Operation <br />COLORADO <br />DIVISION OF <br />RECLAMATION <br />MINING <br />SA FETY <br />Bill Ritter, Jr. <br />Govema <br />Harris D. Sherman <br />Executive Director <br />Ronald W. Canny <br />Division Director <br />Natural Resource Trustee <br />Permit # M _ (Please reference the filLgurnber 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 - - - (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. ApD licant/ouerator or company name (name to be used on permit): LINCOLN COUNTY <br />1.1 Type of organization (corporation, partnership, etc.): Local Govemment <br />2. Op eration name (plot. mine or site name): JAMACO Pit <br />3. Permitted acreaee (new or existing site): 9.81 permitted acres <br />3.1 Change in acreage (+) acres <br />3.2 Total Acreage in Permit Area 9.81 acres <br />4. Fees: <br />4.1 New Application: $1,258.00 application fee <br /> Amendment Fee (C.R.S. 34-32.5-125(II)): 27.00 application fee <br />4.2 Conversion Fee (from 110d to 110 2$.696.00 conversion fee (Rule 1. 11.2(2)) <br />5. Primary commoditie(s) to be minted: Sand Gravel <br />5.1 Incidental commoditie(s) to be mined: 1. 0 / 0 lbsffons/vr 2. 0 / 0 Ibs/Tons/vr 3. 0 / 0 1bsPTons/y; <br />4. 0 / 0lbs/Tons/vr 5. 0 / 0 lbsiTons/yr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Construct and maintain county roads <br />Anticipated end use of incidental commoditie(s) to be mined: Not Applicable <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines