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~M - <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ECElVED <br />Department of Natural Resources <br />7313 Sherman St., Room 275 <br />Denver, Colorado 80203 JUN 0 8 2004 / - o i v t s i o N O F <br />Phone: (303) she-3sa~ MINERAL S <br />FAX: (303) s32-8106 ~ Division of Minerals aaJ 6eolagy G E O L O G Y <br />CONSTRUCTION MATERIALS FILE COP R E C L A M A T I O N <br />REGULAR (112) OPERATION / FOR SCA F E l' Y <br />RECLAMATION PERMIT APPLICATION FORM asl Owens <br />Governor <br />Greg E. Walther <br />Executive Direcror <br />IECK ONE: _ New Application (Rule 1.4.5) X Amendment Application (Rule 1.1 i[hael B. long <br />bivision Director <br />_ Conversion Application (Rule 1.11) <br />Permit # _~- ~0 -~- 0 21 (provide for Amendments and Conversions of existing permits) <br />e application for a Construction Materials Regulaz 112 Opcration Reclamation Permit contains three major parts: (1) the application form; <br />~ Exhibits Ate, Addendum 1, any sections of Exhibit 6.5 (Geotechnical StabilityExbibit; and (3} the application fee. When you submit your <br />plication, be sure to include one (1) complete siened and notarized IVORY ORIGINAL and fom (4) copies of the completed I~ <br />p]ication form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical StabilityExhibit, and a check for the . <br />plication fee described under Section (4) below. Exhtbits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1(L" X 11" <br />8 lll" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />Apolicant/oaerator or comoanv name (name to be used on aermitl: Ranch T,an r] T,T,(' ~ <br />1.1 Type of organization (corporation, pazmership, etc.): T.T.O <br />1.2 I.R.S. Taz I.D. No. or Social SecuriryNttmber: <br />84=t5856tt <br />Operation name (nit, mine or site name): Ranch Land Rock Pit #~ <br />Permitted acreage (new or existine site): 711 f1 permitted acres <br />3.1 Change in acreage (+) 6 80 ~~ <br />3.2 Total acreage in Permit azea <br />Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Pee <br />4.5 Conversicn to 112 operation (set by statute) <br />Primary commoditie(s) to be mined: gravel <br />5.1 Incidental commoditie(s) to be mined: 1. ]bs/I'ons/vr <br />3. / 1bs/Tons/kr 4. / lbs/I'ons/vr <br />9 20 acres <br />$2.344.00 application fee <br />$2.906.00 quarry application <br />$1.938.00 amendment fee <br />$2.344.00 conversion fee <br />2. / Ibs/1'ons/vr <br />5. / Ibs/I'ons/fir <br />5.2 Anticipated end use of primazycommoditie(s)tobemined: construction material <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />