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STATE OF COLOFADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources ??? d4-41* <br />1313 Sherman St., Room 215 b M ? EI VEID <br />Denver, Colorado 80203 C O L O R A D O <br />Eshone (303) 86&3567 M- t D I V I S 1 O N o f <br />PAX: (303) 832-8106 ' ` 7O `' -0 ' MAR 0 2 2011 RELATION <br />MINING GRAND JUNCTION FIELD OFFCE <br />60 FETY <br />W' ?nONSION OF SA MINING <br />MAR 08 ?011 CONSTRUCTION MATERIALS SAF• <br />Bill Ritter, Jr. <br />p; ,zlion of Reclamation, LE ITED IMPACT (110) OPERATION Governor <br />IJining 4;;d Safaty <br />Harris D. Sherman <br />RECLAMATION ]PERMIT APPLICATION FORM Executive Director <br />Ronald W. Cattany <br />07mision Din"or <br />CHECK ONE: There is a File Number Already Assigned to this Operation Natural Resource Trvstea <br />Permit # M -9411 -Ol (Please reference the file number currently assigned to this operation) <br />X New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit j# 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: (I) 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) conrolete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies <br />,f Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for <br />.ne application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1/2" 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 infornmation described below. <br />1. A.u Heant/ouerator or company mane (name to be used on aeermit): B r P B a S i ri R e ? n z, i c e s ___ <br />1.1 Type of organization (corporation, partnership, etc.): Colorado Corporation <br />2. Operatioa name (tsit. Heine or site name): _ 1? -r B n t r e s s c; rave ] Pit <br />3. Permitted acr _e (anew or ezift site): 9 . 9 permitted acres <br />3.1 Change in acreage (+) 0 acres <br />3.2 Total Acreage in Permit Area 9 . 9 acres <br />4. Fees: <br />4.1 New Application: $1,258.00 application fee <br />Amendment Fee (C.R.S. 34-32.5-125((n)): 27.00 application fee <br />4.2 Conversion Fee (from 110d to 110 $2.696.00 conversion fee (Rule 1.111 (2)) <br />5. Primary commnodatie(sI to be mined: sand r a ve 1 <br />5.1 Incidental commoditie(s) to be mined: 1. 0 / lbggonslvr 2. I 1bs/Tons/vr 3. / 1bstTons/vr <br />4. / lbsri'ons/vr 5.. / lbs(Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Construction materials <br />Anticipated end use of incidental commoditie(s) to be mined: <br />Office of <br />Mined Land Reclamation Danupr a rranA t..n.ot.... - n... Office of