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DIVISION OF RECLAMATION, MINING AND SAFETY <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 />Pe rf# _2.006 010 <br />New Application (Rule 1.4.5) <br />Conversion Application (Rule 1.11) <br />CW�1 <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: I 1 There is a File Number Already Assigned to this Operation <br />Hanis D. Sherman <br />(Please reference the file number currently assigned to this operation }ecutive Director <br />Amendment Application (Rule 1.10) <br />Permit # M _ 2006 010 - (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. Applicant/onerator or company name (name to be used on permit): Las Animas County <br />1 1 Type of organization (corporation. partnership, etc.): Unit of County Government <br />2. Operation name (pit, mine or site name): Feister Pit <br />3. Permitted acreage (new or existing 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: road base barrow rip rap <br />5 1 incidental commoditie(s) to he mined: 1. none - lbs'Ton_s /yr <br />3. 1bs/Tonsiyr 4 / lbs /Tons'vr <br />Office of <br />Mined Land Reclamation <br />STATE OF COLORADO <br />Denver • Grand Junction • Durango <br />2. <br />9.99 <br />17.11 <br />27.1 <br />5. / <br />RECEIVED <br />JUN 2 5 2012 <br />Division of Reclamation, <br />Mining & S <br />COLORADO <br />DIVISION OF <br />RECLAMATION <br />MINING <br />SAFETY <br />Bill Ritter, Jr. <br />Governor <br />Ronald W. Cattany <br />Division Director <br />Natural Resource Trustee <br />permitted acres <br />acres <br />acres <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 />lbsiTons/ yr <br />His/Tons/1,T <br />3.? Anticipated end use of primary commoditie(s) to he rained: road base for County roads, fill material, erosion control <br />5.3 Anticieated end use of incidental commoditie(s) to be iitincd.nk <br />Office of <br />Active and Inactive Mines <br />