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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 />M- 2015 -008 <br />STATE OF COLORADO <br />DIVISION OF RECLAMATION <br />MINING AND SAFM <br />CONSTRUCTION MATERIALS <br />SPECIAL (i11) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />COLORADO <br />D I V I S I O N Of <br />RECLAMATION <br />MINING <br />SAFETY <br />The application for a Construction Materials Special 1 l l Operation Reclamation Permit contains fourmajor parts: (1) the application form; <br />(2) Exhibits A -L, Addendum 1, and any sections of Exhibit 6.5 (Geotechnical Stability Exhibit), as required by the Office, and outlined in <br />Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); (3) the application fee; (4) the Performance Warranty and ifrequired a Financial Warranty. When <br />you submit your application, be sure to include one (1) completed, sii=ned and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A -L, Addendum 1, appropriate sections of Exhibit 6.5 (Geotechnical Stability Exhibit), as <br />required, a check for the application fee described under (4) below, and the fully executed Performance Warranty and Financial Warranty, if <br />required. Exhibits should NOT be bound or in 3 -ring binders; maps should be folded to 8 2" X I I" or 8 2" X 14" size. To expedite <br />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 described below <br />I. Applicant /operator or company name (name to be used on the permit): <br />Kirkland Construction, L.L.L.P. <br />1.1 <br />Type of organization (corporation, partnership, etc.): Limited Liability Limited Partnership <br />2. Operation name (pit, mine or site name).. Blue Valley Pit <br />3. Permitted acreage: <br />4_ New Application: <br />30 Permitted Acres <br />5848.00 Application Fee <br />5. Primary commoditle(s) to be mined: Base Course, Asphalt Aggregate, Embankment, Concrete aggregates, Bedding /Backfill <br />6. Name of owner to the surface of affected land: Galloway Inc. DBA Blue Valley Ranch <br />7. Name of owner to the subsurface riohts of affected land: State Land Board <br />8. Tvpe of mining operation: 0. Surface EJ Underground <br />L3 In -situ <br />9. Location information: The center of the area where the majority of mining will occur: <br />CO Grand <br />PRINCIPAL MERIDIAN (check one): � 6th (COlorado)— 10th (New Mexico) 0 Ute <br />SECTION (write number): S 16 <br />TOWNSHIP (write number and check direction): T 1 North South <br />RANGE (write number and check direction): R 80 East ✓ West <br />QUARTER SECTION (check one): NE NW SE SW <br />QUARTER/QUARTER SECTION (check one): r _,E >� NW ✓ SE E SW <br />GENERAL DESCRIPTION: (the number of miles and direction. from the nearest town and the approximate elevation): <br />7 miles south of Kremmlena Colorado, 75851 <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />