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A STATE OF COLORADO <br />DIVISION OF RECI M "ON, MINING AND SAFETY <br />DepartrneriofNatural Aemrcea q <br />1313 9wrron SL, Room 215 NO V 12 `01 O L O RA D O <br />"'°r• COIO?O (30203 CONSTRUCTION MATERIALS I?N 01 R a .v t a r o plot <br />Phone: (303) 1166-3567 <br />FAX: (303) 832-8106 REGULAR (112) OPERATION • l and MINING <br />RECLAMATION PERMIT APPLICATION FORM SAF&E'TY <br />t3ECK ONE _n There Is a Fite Number Already Assigned to this Operation <br />am itiar,lr. <br />covrnor <br />80 041 ila * D. sheman <br />18 <br />p _ (please reference the file number currently assigned to this operatioz)w.*a m mew <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) R=W w. cony <br />Division Diro, , <br />? Conversion Application (Rule 1:11) tanrat RAsoaee TWO <br />Permit # _M - - (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 aimed an 'aotatized ORIMAAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechmcai 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; maps should be folded to <br />a 112" X 11" or S 112" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERA73ON INFORMATION <br />Type or print dearly, In the space provided, Lam. information requested below. <br />1. Aonlicant/oaerator or Mmaanv name name to be used on yerrnit) : James L. Treat <br />1.1 Type of organization (corporation, parinem »p, etc.): Individual <br />2. Operation name (pit. mfne r site name): Rock Gulch Gravel Pit <br />3. Permitted acreage (newt or existing site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />9.8 permitted acres <br />16.3 acres <br />26.1 acres <br />4. )its: <br />4.1 <br />New Application <br />$2.696.00 <br />spplicationfee <br />4.2 New Quarry Application _2.00 quarry application <br />4.4 Amendment Fee 52.229.00 amendment fee <br />4.5 Conversion to 112 operation (sec by statute) 52.696.00 conversion fee <br />5. Pjsn arv commoditle(s) to be mined: gravel sand <br />5.1 Incidental commoditie(s) to be mined: 1. - lbsrrons/vr 2. / lbslTons/vr <br /> 3. / lbsrrons/vr 4. / 1bsrlons/vr S. / Ibsri'ona/w <br />5.2 Anticipated end use of primary commoditie(s) to be mined: construction material <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />Office d Office of <br />Mined Land Reclamation Denver • Grand luncilon • Durango Adve and inaQive Mines