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ii iiiiiiiiniu iii <br />999 <br />• 4 <br />STATE OF <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St., Room 21 S <br />f3enver, Colorado 80103 <br />Phone: (303) 866.3567 <br />FAX: (3031 8321(% <br />COMSTROCTIOA MATER>•LT.G <br />COLORADO <br />~~~~~ <br />0~8 ~~y <br />s~9 <br />L]1SITED Il@A~CT~~O;P-EIRATI~tO~)'S (110) <br />'r?v*TION PERMIT' AP1P/1`.ICATZOH PORN <br />DEC 1 p 1997 <br />Roy Barter <br />Governor <br />Mmes 5. Lorhhead <br />fiecutise Direaar <br />Miduel 8. Lard <br />~~IYIp IPn FI tJllnafR4 1L ,~i+,1~M11(~, Div'rsbn Dimclor <br />CFiECR oME: ~ Mew Application (Rule 1.4) a~e..,~~nt Application (C. R. S. 34-32.5-110) <br />Conversion Application (Rule 1.11) <br />Permit # ~-~_-~~_ (provide for Aaeadtaents and Conversions of <br />existing permits) <br />The application for a Construction Materials Limited Zmpact Mining (110) Operation Reclamation <br />Permit contains three major parts: (1) the application form; (2) Exhibits A-J and Exhibit L, <br />Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by the <br />Office, and outlined in Rules 6.1, 6.2, 6.3, and 6.5; and (3) the application fee. Khen you <br />submit your application, be sure to include one (1) complete sinned and notarized IVORY ORIGTI~IL <br />and one (1) copy of the completed ivo application form, two (2) copies of Exhibits A-J and <br />Exhibit L, appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check <br />for the application fee described wader (4) below. Exhibits should NOT be bound or in a 3-ring <br />binder; maps should be folded to 8 1/2' % il' or 8 1/2" % 14' size. To expedite processing, <br />please provide the information in the format and order described in this form. <br />--- -_ -= GERERAL OPERATION IAFORHATIOM-- rn . C]~ - ~ O ~ - - <br />Type or print clearly, in the space provided, all information described below. <br />1 Applicant/operator or company name (name to be used on permit): <br />1.1 Type of organization (corporation, partnership, etc.)/: ~ <br />1.2 I.R.S. Tax ID No. or Social Security Number: By "~ G O O - <br />2. O-Aeration name (pit, mine or site name): <br />3. Permitted acreaae (new or existing site): <br />3.1 Change in acreage (+ or -) <br />Total Acreage in Permit Area <br />4. Fees: <br />,(3/'G~SO~ /'i f <br />9, 9 y permitted acres <br />acres <br />acres <br />4.1 New Application 5875.00 application fee <br /> Amendment Fee (C.R.S. 34-32.5-125(ii)) 5575.00 ~ application fee <br />4.2 Conversion Fee (from 110d to 110 85 75.00 conversion fee (Rule 1.11.2(2)) <br />5. Primary commoditie(s) to be mined: /'a Vc ~ , <br />S.I Incidental commoditie(s) to be mined: 1. - lbs/Tons/vr <br /> 2. / lbs/Tons/vr 3. / lbs/Tons/vr <br /> 4. / lbs/Tons/vr 5. lbs Tons r <br />5.2 Anticipated end use of primary commoditie(s) to be mined: C'4. a ~ ,Pow /~O/n fCndnc~ <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />