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STATE OF COLORADO <br />DPVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources RECEIVED <br />1313 Sherman St., Room 215 CLNDenver, Colorado 80203 MAR O �� 7 <br />Phone -(303)866-3567 1 <br />FAX: (303) 832-8106 .11 Violation: DIVISION OF RECLAMATION <br />MV -2016-061 MINING & SAFETY <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE. Iv i There is a File Number Already Assigned to this Operation <br />COLORADO <br />DIV1sION of <br />RECLAMATION <br />MINING <br />SAFETY <br />Permit"I M- - - 6 (Please reference the file number currently assigned to this operation) <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule LH) <br />Permit # M - -0--0— - (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 (I) 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 I I" or 8 112" 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. Annlicant/operator or company name (name to be used on permit): Wagner Construction, Inc. - <br />1.1 Type of organization (corporation, partnership, etc.): Corporate <br />2. Operation name (nit, mine or site name): Wagner Rock Pit <br />3. Permitted acreage new or existing site),: <br />9.74 <br />permitted acres <br />3.1 <br />Change in acreage (7) <br />18.17 <br />acres <br />3.2 <br />Total acreage in Permit area <br />27.91 <br />acres <br />4. Fees: <br />4.1 <br />New Application <br />$2.646.00 <br />application fee <br />4.2 <br />New Quarry Application <br />_$3,342.00 <br />quarry application <br />4.4 <br />Amendment Fee <br />$2,229.00 <br />amendment fee <br />4.5 <br />Conversion to 112 operation (set by statute) <br />$2.646.00 <br />conversion fee <br />5. Primary commodities to be mined: gravel rock <br />5.1 <br />Incidental commoditie(s) to be mined: 1. _ lbs/Tons/vr <br />2. 1 <br />Ibs/Tons/vr <br />3. I lbs/Tonslvr 4. 1 Ibs/Tons/vr <br />5. / <br />lbs/Tons./vr <br />5.2 <br />Anticipated end use of primary commoditie(s) to be mined: Construction Materials <br />5.3 <br />Anticipated end use of incidental commodities) to be mined: NIA <br />