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<br />STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />COLORADO <br />Denver, Colorado 80203 <br />Phone: (303) 866.3567 CONSTRUCTION MATERIALS DIVISION o F <br />RECLAMATION <br />FAX: (303) 832-8106 REGULAR (112) OPERATION MINING <br />RECLAMATION PERMIT APPLICATION FORM SAFETY <br /> <br /> Bill Ritter, Jr. <br />CHECK ONE: ? There is a File Number Already Assigned to this Operation Governor <br /> <br />Pu Harris D. Sherman <br />. M (Please reference the file number currently assigned to this operatioit)ecutive Direcmr <br /> ff New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Ronald W. Cattany <br /> <br />1 <br />7 <br />lication (Rule IA 1) <br />Conversion A Division Director <br />Natural Resource Trustee <br /> pp <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 signed and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical 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 />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. <br /> GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />1. Applicapt/operator or company name (name to be used on permit): J & P Trucking <br /> 1.1 Type of organization (corporation, partnership, etc.): Sole Proprietorship <br />2. Operation name (pit, mine or site name): J & P Trucking Pit #1 <br />3. Permitted acreage (new or existing site): 155.2 permitted acres <br /> 3.1 Change in acreage (+) RMCRlVED g•g acres <br /> 3.2 Total acreage in Permit area MAR 212011 155.2 acres <br />4. Fees: Division of Reclamation, <br />4.1 New Application <br />?2.696.00 <br />application fee <br /> Mining & Safety <br /> 4.2 New Quarry Application $3,342.00 quarry application <br /> 4.4 Amendment Fee $2.229.00 amendment fee <br /> 4.5 Conversion to 112 operation (set by statute) $2.696.00 conversion fee <br />5. Primary commoditie(s) to be mined: Gravel Sand Fill Material <br /> 5.1 Incidental commoditie(s) to be mined: 1. - NA lbs/Tons/vr 2. / lbs/Tons/vr <br /> 3. / lbs/Tons/vr 4. lbs/Tons/vr 5. / lbs/Tonslvr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Will depend on consumer's desired application <br />5.3 Anticipated end use of incidental commoditie(s) to be mined:NO incidental commodities anticipated at this time <br />AP Trucking Pit #1 <br />Page 1 <br />Office of Office of <br />LA-4 1...el f7-A 1.-s:.... . M-- ' •?..._ __A .__-t.._