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~~ ~ ~ <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION / APR 2 2 2C05~ <br />RECLAMATION PERMIT APPLICATION FO <br />,,^ivi;ioa 7f . ih ra': v: ^.nnlopq <br />CHECK ONE: / There [s a File Number Already Assigned to this Operation <br />Permit # M •_ , _ (Please reference Ute file number cutrenUy assigned to this operation) <br />_ New Application (Rule 1.4.5) / Amendment Application (Rote 1.10) <br />_ Conversion Appii lion (Rule Ll l) <br />Pemtit # M -1977 - 526 -_ (provide for Amendments and Conversions of existing pernizs) <br />The application for a Construction Materials Regulaz 112 Operation Reclamation Permit contains three major pans: (1) the application <br />form; (2) Exhibits A-S, Addendum 1, any sections of Exlilbit 65 (Geotechrical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to include one (I) complete signed and notarized ORIGINAL and one (1) copy of the completed. <br />application form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps stwuld be folded to <br />8 1/2" X I I" or 8 1/2" X L4" size. To expedite processing, please provide Ute information in the format and order described in this fomt. <br />GENERAL OPERATION <br />Type or print clearly, In the space provided, ~ information requested below. <br />1. AoolicanUoaerator or comnanv name (name to be used on oermitl: Albert Ftel and SOILS, 1nC. / <br />1.1 Type of organization (corporation, partnership, etc.): C'mm~ratinn <br />1.2 I.R.S. Tax I.D. No. or Social Security Number. <br />2. Operation name (oit. mine or site Hamel: WOrthirig Plt <br />3. Permitted acreage /new or esisti~ site): <br />3.1 Chango in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Am®xirnent Fee <br />4.5 Conversion to l 12 operation (set by statute) <br />5. Primary commoditie(al [o be mined: Sarid gravel <br />S.l Incidental commoditie(s) to be mined: t. - ibs(fonslvr <br />3. / Ibs/I'ons/vr 4. / Ibs/Toas/vr <br />110.60 permitted acres <br />50.30 acres <br />160.90 acres <br />4X80 application fee <br />$2S3~Gif0 quany application <br />$1,938.00 amendment fee <br />SdSS4iDi01) conversion fee <br />2. ! lbs/I'oas/vr <br />5. / lbs/I'ons/vr <br />5.2 Anticipated end use of primary commodite(s) to be ngned: taw COristruetlOri materials, landscaping mek <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />