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• iiiiii-ii-ii--ii~ii CONSTRUCTION MATERIALS REGULAR OPERATION (112) RECLAMATION PERMIT APPLICATION FORM CHECK ONE New Application (Rule 1.4.5) X Amendment Application (Rule 1.10) _ Conversion Application (Rule 1.11) PERMIT # M-77-304 The application for a Regular 112 Operation Reclamation Permit contains three major parts: (1) the application form; (2) Exhibits A- S; and, (3) the application fee. When you submit your application, be sure to include one (1) complete sinned and notarized IVORY ORIGINAL and four (4) copies of the completed ivo~ application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application fee described under Section (4) below. Exhibits should not be bound or in a 3-ring binder; maps should be folded to 1-112" x11" or 8-1/2" x 14" size. To expedite processing, please provide the information in the format and order described in this form. GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, all the information described below. Applicant/operator name: Pete Lien 8 Sons, Inc. dba Colorado Lien Company 1.1 Type of organization Corporation 1.2 IRS Tax ID No or SSAN 2. Operation name: REX QUARRY, M-77-304 3. Permitted Acres 240.0 Permitted Acres 3.1 Change in acreage (+ or -) +160.0 acres 3.2 Total acreage in permit area 400.0 acres 4. Fees: 4.1 New Application 1 875.00 application fee 4.2 New Quarry Application 2 325.00 quarry application fee 4.3 Milling Application (Non-DMO) 3 100.00 milling application 4.4 Amendment Fee 1 550.00 amendment fee 4.5 Conversion to 112 operation 1 875.00 conversion fee S. Primary commoditie(s) to be mined: Limestone 5.1 Incidental commoditie(s) to be mined 1 2 5.2 Anticipated end use of primary commoditie(s) to be mined: 5.3 Anticipated end use of incidental commoditie(s) to be mined: