PERMFILE47372

• Permit No: M2000149
• IBM Index Class Name: Permit File
• Doc Date: 11/29/2000
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT 110 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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999
STATE OF COLOIZ~DO
DIVISION OF MINERALS AND GEOLOGY
DeUartment of Natural Resources RECEIVED
l 1(3 Sherman St.. Room 21 >
Denver, Colorado 80203 D I v i 5 1 0 .~ O
Phone: [phone] CONSTRUCTION MATERLILS NOV 2 9 2000 M I N E RA L
FAX: [phone] &
LIMITED 114iPACT (110) OPERATICvision 9f Minerals and Gevly G E O L O G •
AY aECLAn ATIOr
MINING•SAFEi'
RECLAMATION PERMIT APPLICATION FORM
811 Owens
Governor
Greg E. watcher
CHECK ONE: There is a File Number Already Aasigeed to thin Operation Executive Director
Michael B long
Permit # M -~-[~ -_ (Please reference the fde number currently assigned to this operation) o;,,;s.on oire<tor
R New Application (Rule L4.5) _ Amendmeet Apphcalion (Rule 1. IO)
Convenioe Application (Rule 1.11)
Permit # M -_ (provide for Amepdmepta and Cooveniovs of existing permits)
The application for a Construction Materials Limited Impact (I10) Operation Reclamation Permit contains thtrx major parts: (I) the
application form; (2) Exhibits A-J, Exhrbit L, Addendum 1, any sectiovss of Exhibit 6.5 and Geotechaical Stability Exlubi[, as required by the
Office, and outlined in Rules 6.1, 6.2, 6.3, 6S, and 1.6.2(1)(b); and (3) the application fee. When you submit yo>a appticatiov, be sure to
include one (l) complete si¢.ned and notarized IVORY ORIGIlYAL and one (1) copy of the completed No application form, two (2) copies
of Exhibits A-J, Exhibit L, Addendum I, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a checA for the
application fee described order (4) below. Exhibits should NOT be bound or in a 3-ring binder, maps should be folded to 8 1/2" X 1 I" or
8 1/2" X 14" ,ize. To expedite processing, please provide the information in the forma[ and order described in [his form.
GENERAL OPERATION INFORMATION
Type or print clearly, ie the space provided, ALL information described below.
1. AppGcapt/ooerator or comesev came (came to be used oe permit):
1.1 Type oforgavize[ion(corporatiov,permenhip,etc.): Individual
1.2 I.RS. Tax ID No. or Social Security Number: 2.:
2. Operatiopeame(pit,mineoraiteeame): Todd Dysart
3. Permitted acreaee (pew or e:iatie¢ aka): 9.183 permitted acres
3.1 Chapge in aaeage (+) saes
Total Aaeage in Permit Area 9.183 acres
4. Feea:
4.I NewApplicatiov: "WAIVED" PER $}$949 applica[iovfee
Amepdmev[ Fee (C.RS. 34-32.5-125(II)): BRUCE HUMPHRIES ~}9g~ application fee
4.2 Conversion Fee (tiom I I Od to l l0 HS 75.00 wnversiov fee (Rule L I l.2(2))
~. Primary rnmmoditie(al to be mined: Grave 1
5.I Incidental commodities} to be mined: {. / Ibsffo_ys7 r 2. 7 IbslCoos/vr 3. / Ibs7ions/vr
4. / Ibs/I'o_ us/ 5. / Ibs/Tov_~ ,
5.2 Mticipatedevdaseofprimarycommodi[ie(s)tobemined: General Public Use
Anticipated end use of incidental commoditie(s) to be mined:
* Road Base, Landscaping