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<br /> <br />w ~ III IIIIIIIIIIIIIIII s ~~ ~ <br />DIVISION OF MINERALS AND GEOLOGY <br />Dcpdrlmenl of N,rrural Rc'SUOf(:Q$ • <br />131 S ]herman SL, Room ? 15 <br />Denver. Cobrado N0203 <br />Phune: (70:41 n66-35hi <br />FAX: 1 4071 N3'_-tl106 REC~wE~ <br />RADO <br />.~ „~ V ..~~yVyV <br />d9a <br />CPa/ <br />JUG ~ 5 X101 <br />Oiysio~~~ Fj <br />n o)(y/nereW OyACe <br />,ul O 9 ~QQ, CONSTRUCTION MATERIALS a/sg Goo( <br />,~,,~o~yyI~GULAR (112) OPERATION °9Y <br />DIV1SlopptMlpetasB~LG~7t1A770N PERMIT APPLICATION FORM <br />~' 201- 0 (~~ <br />~~ <br />DIVISION O F ~ <br />MINERALS <br />GEOLOGY <br />RECLAMATION <br />MINING•SAFETY <br />aril Owens <br />Grnernur <br />Creq E. wulche~ <br />E.eculive Director <br />CHECK ONE: X New A lication Rule 1.4.5) Amendment A lication Rule 1.10""noel e. tong <br />PP ( PP ( 2)wislon Director <br />_ Conversion Application (Rule 1.1 I ) <br />Permit # M -_ -_ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Mazerials Regular 1 I Z Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geo[echnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) comolete signed and notarized IVORY ORIGINAL and four (4) copies of the completed lvorv <br />application form, five (5) 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 m this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, io the space provided, ALL information requested below. <br />A4plicaot/ooentor or comosnv name (Dame to be used o0 oermitl: ASPHALT CONSTRUCTORS , INC. <br />1.1 Type of organ'vation (corporation, partnership, etc.): CORPORATION <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: <br />2. Operation Dame (nit. mine or site name): DFT. NORTF WFST VAT.T.F.Y PTT <br />3. Permitted acreaee (new'or existine site): 45.97 permitted acres <br />3.l Change in acreage (+) acres <br />3.2 Total acreage in Permit area 45.47 acres <br />4. Fees <br />4.1 New Application $1.875.00 application fee <br />4.2 New Quarry Application $2.325.00 quarry application <br />4.3 Milling Application (Non-DMO) $3.100.00 milling application <br />4.4 Amendment Fee $1.550.00 amendment fee <br />4.5 Conversion to 112 operation (set by stam[e) $1.875.00 conversion fee <br />5. Primary commoditiefs) to be mined: SAND GRAVEL <br />5.1 Incidental commoditie(s) to be mined: I. NONE - Ibslfons/vr 2. / Ibs/fons/vr <br /> 3. / Ibslfons/vr 4. / Ibslfons/vr 5. / Ibs/Tons/vr <br />52 Anticipated end use of primary commoditie(s) to be mined: CONSTRUCTION AGGREGATES <br />5.3 Anticipated end use of incidental commoditie(s) [o be mined: N/A <br />