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DIVISION OF RECLAMATION, <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832 -8106 <br />woo <br />JUN O g 2 09 <br />STATE OF COLOFADO <br />MINING AND SAFETY or tteC. <br />piwa! and Safes!' <br />w <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />Permit # M - (Please reference the file number currently assigned to this operatit W. cattany <br />X New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Division Director <br />Natural Resource Trustee <br />Conversion Application (Rule 1.11) <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 I, 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 of6.5 (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. Applicant/operator or company name (name to be used on permitt: Grand Junct ion Concrete Pipe Co . <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />2. Operation name (pit, mine or site name): Gunnison River Gravel <br />3. Permitted acreage (new or existins site): <br />3.1 Change in acreage ( +) <br />3.2 Total acreage in Permit area <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. Primary commoditie(s) to be mined: Sand and Gravel <br />5.1 Incidental commoditie(s) to be mined: 1. <br />rn ao09- 04R <br />Pits <br />lbs/Tons /yr 2. / <br />$2,696.00 <br />$3,342.00 <br />$2.229,00 <br />$2.696.00 <br />COLORADO <br />DIVISION OF <br />RECLAMATION <br />MINING <br />— &— <br />SAFETY <br />Bill Ritter, Jr. <br />Governor <br />Harris D. Sherman <br />Executive Director <br />S R _ 3 permitted acres <br />acres <br />58.3 acres <br />application fee <br />quarry application <br />amendment fee <br />conversion fee <br />ibs/fons /yr <br />3. / lbs/1'ons/yr 4. / lbsJTons/yr 5. / lbs/Tonslyr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Construction Material and Aggregate for Concre' <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />