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FILE COPY <br />FOR SCAi~1`E C <br />DIVISION OF MINERALS AND GEOLOGM <br />Department of Nawral Resources <br />1313 Sherman S[., Room 215 <br />Denver, Colorado 80203 <br />Phone: 1303) 866-3567 <br />FAX: (303) 832-8106 <br />CONSTRUCTION MATERIALS <br />/-~-a-~~-a68 <br />R~~t7~~9 <br />~~, 09~ oa <br />JUN 1.1 2002 <br />Division of Minerals and Geology <br />LIIIITTED IMPACT (110) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />~~ <br />DIVISION OF <br />MINERALS <br />GEOLOGY <br />RECLAMATION <br />MINING•SA FETY <br />Bill Owens <br />Governor <br />CHECK ONE: There is a File Number Already Assigned to thin Operation <br />Greq E. Wakher <br />Executive Director <br />Permit # M -~~~ D~ lease reference the file nlmmber cuaent assi ed to this o erasion Michael e. Lang <br />ly ~ P ) Division Director <br />~_ New Application (Ante 1.4.5) <br />Conversion Application (Rule 1.11) <br />!Amendment Application (Rule I.10) <br />Permit # M -_ _ _ (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the <br />application form; (2) Exhibits A-J, Exhibit 1-, Addendum 1, a~ sections of Exhibit 6.5 and Geotechnical Stability Exlibit, as required by dre <br />Office, and outlinedm Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When yon submit your application, be sure to <br />iaclnde one (1) complete sued and notarized NORY ORIGINAL and one (]) copy of the compktod ITS application form, two (2) copies <br />of Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geoteclmical Stability Exhibit), as required, and a check for the <br />application fee described under (4) below. Exhibits should NOT be boned or in a 3-ring binder, maps should be folded to 8 1/2" X 11" or <br />812" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENER4L OPERATION INFORMATION <br />Type or print clearly, in the apace provided, ALL uttormation described below. <br />1. A lice t/o erator r com an name name to be used oe errnit <br />Rick Ensminger <br />1.1 Type of organization (corporation, partnerslrip, etc.): Individual owner -private <br />l.2 LAS.TaxIDNo.orSocialSecurityNnmber.2.: <br />2. Operation name (ok. mine or site camel: Ensminger Pit <br />3. Permitted acreaee fpew or eristip¢ site): 9.9 permitted acres <br />3.1 Change in acreage (+) acres <br />Total Acreage is Permit Area acres <br />4. Fees: <br />4.1 New Application: $1.094.00 application fee <br />Amendment Fee (C.R.S. 34-32.5-125(II)): 5719.00 application fee <br />4.2 Conversion Fee (from 110d to 110 8S 75.00 conversion fee (Role 1.11.2(2p <br />~. Primary cemmoditie(s) to be mined: Gravel Sand Clav <br />5.1 Incidental commoditie(s) to be mined: 1. / lbs/fons/vr 2. / lbslTons/vr 3. / lbs/'fonslvr <br />4. / lbs/Tons/vr 5. / lbs/Tons/vr <br />5.2 An[icipatedendaseofpmnarycommoditie(s)tobemined: Construction material <br />Anticipated end use of incidental commoditie(s)tobemined: Cnnstrrrction material <br />