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CIF COLORADO <br /> DIVISION OF <br /> Dw� t1.()547313 She,Denver C O O C T 1 Z 0 1 R C I I13 RADO <br /> 2s v DIY1510N O! <br /> Ph«w.(34 ac RECLAMATION <br /> FAX:(303) AMv m DIVISION OF RECLAMATION MII&NG <br /> MINING AND SAFETY SAF ETY <br /> CONSTRUCTION MATERIALS <br /> SPECIAL(I It)OPERATION <br /> RECLAMATION PER4iIT APPLICATION FORM <br /> The application fora Construction Materials Special I I I Operation Reclamation Permit contains four major parts:(I)the application form; <br /> (2)Exhibits A-L,Addendum I,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 if required a Financial Warranty_When <br /> you submit your application,be sure to include one(1)completed,signed and notarized ORIGINAL and one(I)copy of the completed <br /> application form,two(2)copies of Exhibits A-L„Addendum I,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 I=be bound or in 3-ring binders;maps should be folded to 8 2"X 11"or 8 2"X 14"size, To expedite <br /> processing,please provide the information in the format and ordcr described in this form. <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly,in the space provided,all information described below <br /> L Applicant/ocerator or company name(same to be used on the permit): <br /> SEMA Construction,Inc. <br /> 1.1 Type of organization(corporation,partnership,etc.}: ��mt�orl ___ <br /> 2. Operatlon name(pit,mine or site name): D1Qhl_BOfTow Pd <br /> 3. Permitted acreaee: 26.9•- Permitted Acres <br /> 4. New Application: $898.00 Application Fee <br /> 5. Primary commodities)to be mined: Borrow Material(Soil) <br /> 6. Name of owner to like surface of affected land: Rod Diehl <br /> 7. Name of owner to the subsurface rights of affected land: Rya Diehl <br /> 8. Type of mining operation: �✓ ,Surface El Underground F_]to-situ <br /> 9. .Location information: The center of the area where the majority of mining will occur: <br /> Larimer <br /> PRINCIPAL MERIDIAN(check:.one): COUNI <br /> _U 6th(Colorado) I Oth(New Mexico) ElUte <br /> SECTION(write ntunber): S 23 <br /> TOWNSHIP(write number and check direction): T lO North South <br /> RANGE(write number and check direction): R 68 _ East 1✓ I West <br /> QUARTER SECTION(check one): ✓ _ NE _NW SE SW <br /> QUARTER/QUARTER SECTION(check one): _ NE NW SE ✓ SW <br /> GENERAL DESCRIPTION:(the number of miles and irection from the nearest town and the approximate elevation): <br /> Office of Office of <br /> Mined Land declamation Denm• Grand lundlon • Durango Active and Inactive Mines <br /> 6 <br />