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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 COLORADO <br />Phone: (303) 866-3567 CONSTRUCTION MATERIALS OF <br />MATION <br />FAX: (303) 632-8106 REGULAR (112) OPERATION NING <br />RECLAMATION PERMIT APPLICATION FORM SAFETY <br />Bill Ritter, Jr. <br />CHECK ONE: ? There is a File Number Already Assigned to this Operation Governor <br />Hams D. Sherman <br />Pe M (Please reference the file number currently assigned to this operation)ecu&e Director <br />i...-........i New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Ronald w. catta"y <br />Division Director <br />Conversion Application (Rule 1.11) Natural Resource Trustee <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. Ayolicant/onerator or company name (name to be used on permit): Keyah Grande Lodge and Elk Ranch <br />1.1 Type of organization (corporation, partnership, etc.): Keyah Grande Lodge and Elk Ranch <br />2. Operation name (pit, mine or site name): Keyah Grande Aggregate Mining Operation <br />3. Permitted acreage (new or existing site): 34 permitted acres <br />3.1 Change in acreage (+) NA acres <br />3.2 Total acreage in Permit area 34 acres <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5 <br />Primarv commoditie(s) to be mined: gravel <br />$2,696.00 application fee <br />$3,342.00 quarry application <br />$2,229.00 amendment fee <br />$2,696.00 conversion fee <br />5.1 Incidental commoditie(s) to be mined: 1. gravel_ 29,232 lbs/Tons/yr 2. / lbs/Tons/yr <br />3. / Ibs/Tons/yr 4. / lbs/Tons/vr 5. ! lbs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: The aggregate will be processed onsite and sold to local users <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: NA <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines