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STATE ~ COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />DrParlmenl of Nalu ra Resources <br />I S I 1 Sherman il., Ruom ] I i <br />Urnver. Colorado HU_'U3 <br />Phone: I SU iI Hbfi-}567 <br />FA%: I SO.t1 H12-8106 <br />III IIIIIIIIIIIII III <br />999 <br />~~ <br />RECEIV ~~~~ <br />ED <br />DEPARTMENT OF <br />JUL O1 1996 I`1ATURAL <br />RESOURCES <br />Division o(Minerals & Ge010 V <br />9l Roy Romer <br />FORM Governor <br />lames 5 Loch head <br />E.ecunve Dvenor <br />Michael B Lonti <br />Division Director <br />CONSTRDCTION MATERIALS <br />REGOS.AIi (112 ) OPERATION <br />ATION PERMIT APPLICATIO: <br />CHECK ONE: _)~ New Application (Rule 1.4.5) <br />Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # - -_ (provide for Amendments and Conversions of <br />existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains <br />three major parts: (1) the application form; (2) Exhibits A-S, Addendum 1, any sections of <br />Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your <br />application, be sure to include one (1) complete sinned and notarized IVORY ORIGINAL and four (4) <br />copies of the completed Ivorv application form, five (5) copies of Exhibits A-S, Addendum 1, <br />appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application fee <br />described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps <br />should be folded to 8 1/2" X 11" or 8 1/2" X 14" size. To expedite processing, please provide <br />the information in the format and order described in this form. rr ~~[[QQ <br />____________________________________________________________________ ____ __ _~7__~Y_"(I-p-~-7--- <br />GENERAL OPERATION INFORMATION ~~ ~ ~ 058 ~/ O /S Q~ <br />Type or yrint clearly, in the syace yrovided, ALL information requested below. <br />1 Applicant/operator or company name (name to be used on permit): <br />JOHNSON EXCAVATION, INC. <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />1.2 Z.R.S. Tax I.D. No. or Social Security Number: <br />2. Operation name (pit, mine or site name): Tellier Gravel Pit <br />3. Permitted acreage (new or existing site): 25 permitted acres <br />3.1 Change in acreage (+) acres <br />3.2 Total acreage in Permit area 25 acres <br />4. Fees: <br />4. 1 New Application 51,875.00 application fee <br />4. 2 New Quarry Application 52,325.00 quarry application <br />4 .3 Milling Application (Non-DMO) 53,100.00 milling application <br />4 .4 Amendment Fee 51,550.00 amendment fee <br />4 .5 Conversion to 112 operation (set by statute) 51,875.00 conversion fee <br />5. Primary commoditie(s) to be mined: Gravel Sand Fill Material <br />5 .1 Incidental commodicie (s) to be mined: 1. - 80,000 1bs/Tons/vr <br /> 2. / lbs/Tons/yr 3. / 1bs/Tons/vr <br /> 4. / lbs/Tons/vr 5. / lbs/Tons/vr <br />5. 2 Anticipated end use o'_ primary commoditie(s) to be mined: road Cons nt ion <br />5 .3 Anticipated end use of incidental commoditie(s) to be mined: road construction <br />