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r <br />STATE <br />DIVISION OF MINERALS AND GEOLOGY <br />Ckmartment of.I.ttural Rc*wrces <br />11I i Sherman 54„ Room 215 <br />Denvtf, Cultuattu W203 <br />Phone: (303) 06.15b7 <br />FAX:(YU3)n32-ai06 <br />0 1111111 ILI/till 11 <br />)F COLORADO <br />RECEIVED <br />JAN 0 6 2001 <br />D1Vlslan of 111141 ala and Geology <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />0IVIS10N Oti <br />MINERALS! <br />GE0LOGI' <br />RECLAMATION <br />MINING-SAFETY <br />RECLAMATION PERMIT APPLICATION FORM &II Owens <br />Covatrr <br />C,ee F wuckv <br />Eaecutwe D;nrla <br />CHECK ONE: . L New Application (Rule 1.4.5) Amendment Application (Rule 1.10 ?,I, Di ecuw <br />Conversion Application (Rule 1.11) <br />loot- Oar <br />Permit # M _ - W (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 form; <br />(2) Exhibits A-S. Addendum 1, any sections ofExhibk 6.5 (Geotechnicai Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) comidete simied and notarind IVORY ORIGINAL and four (4) copies of the completed vj? <br />application form, five (5) copies of Exhibits A.S. Addendum 1. appropriate sections of 6.5 (Geotecbnictl Stability Exhibit, and a check far <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 />81/20 X 11' or 81/20 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 dearly, is the space provided, tU information requested below. <br />I. Annlbnt/ooerator gr tompaRy same foaWl to be lised an ietmit): Four S4''w6&-- D?csrt m , I 1 f <br />1.1 Type of organbatiion(corporation.partnership. ac.): Lrntiad Uabilu+ C-,mnp a <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: Ed - 15413 <br />2. Operation name (Q& Ming or site camel: Li WF- CAM? 1RT <br />3. Iftmktml sereoffe (new or existii &ft: <br />3.1 Chop in acreage (+) <br />31 Total acreage in Permit area <br />4. Em: <br />4.1 New Applicafm <br />4.2 New Quarry Application <br />4.3 Milling Application (Non-DMO) <br />4.4 Amendment Fee <br />46 Conversion to 112 operation (set by statute) <br />8•? permitted acres <br />S1.875.00 application fee <br />S2,325&2 quarry application <br />S3.I Ob.00 milling application <br />SI-SA0.00 amendment fee <br />_S1.a7s.00 conversion fee <br />S. Primary eomotgole(s) to be mined; S&Idi onc? _ V -' <br />5.1 Incidental commoditie(s) to be mined: 1. Ibslrons/vr 2. I ibYTonslvr <br />3. f lhsllQrtsfvr 4. r tbslTonslvr 5. ! lbsrfonsm <br />5.2 Anticipated end use of primary commoditie(s) to be mined: rpns'i C y=. n aaaM? T <br />5.3 Anticipued end use of incidental commoditie(s) to be mined: