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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Deparmenr of Nafual Rewurces f@'+{~~' <br />~~~ °>~q <br />1313 Sherman St., Room 275 A•~ O L O R A O O <br />Denver, Colorado 80203 •' .4 7 v t s t o n o r <br />Phone: (3037 8663567 CONS1`RUCT'fON ;v1A'1'ERIALS / ~,, „? RECLAMATION <br />fAx: i3o31 a32atoa REGULAR 112 OPERATION n ~ ~+1~~ M [ N [ NG <br />( ) Division ). ? - & - <br />REC'LAbiAT10N PERAIFT APPLICATION FOtL'Ni~p cr J Sa'~'syb SAFETY <br />• - <br />Bil{ (livens <br />Governor <br />CNECK ONE: These is a Filc Number Already Asaigned to this Operation R~s.eu Genrge <br />Permit # VI -_ ~ __ (Please reference the fife number wrren[ly assigned to this opera~fiBSt)"Ve pir.xmr <br />Ronald W. Caltany <br />,New Application (Rule 1.4.5) ,Amendment Application (Raft 1.10) p;,,;:Ion plrec4,r <br />x Conversion Application (Rule L11) Nan,rai Resourcermsn~ <br />Permit ff ~i •~ ~ ; (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A-S, Addendwn I, any sections of Exhibit G.5 (Geotechnicai Stability F.xhihif; and (3) the application fee. When you <br />submit your application, be sure to include one (I) compete sieved and notarized ORFGItYAI, and one (l) copy of the completed <br />application form, two (2) copies of Bxhibits A-5, Addendwn 1, appropriate sections of 6.5 (Geotcebnical Stability Exhibit, and a check for <br />[he application fee described under Section (4) below. Exhibits should N01' be bound or in a 3•ring binder; maps should be folded to <br />H 1;?" X 11" or 8 112" X 14" sire. 'I'o expedite processing, please provide the inforrnation in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, AL1, information requested below, <br />L~tplicanUoperator or company name [name to be used on permit): R.1.~lI;&FSI- Frvrear _.________________,__ <br />L1 Type oforganiration (corporation, partnership, etc.): Tndivi dual <br />2. lt~cration name (nil mine or site name): <br />3. Permitted acreage [new or existine site): <br />it C~tangeinacreage(+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.] New Application <br />4.2 Yew Quarry Application <br />4.4 Amendment Fee <br />4.S Conversion to 112 operation (set by stanne) <br />5. Primary commoditie(s) [o be mined: _~avpl San$-Y,__ Cj~. __.__.- <br />5.1 lncidental commoditie(s) to be mined: I. ,-_„_-_.__-_____~_ Ibslfons/yr <br />3. __.-- ~ ___-- tbs(Consl~r 4. _-- 1 ! Ibs/I'onsltit <br />5.2 Anticipated end use of primary wmmoditie(s) to be mined: _ <br />5.3 Anlicipated end use of incidental commoditie(s) to Im mined: <br />Office of <br />Mirnyi (.and Redama7ion <br />9.9 permitted acres <br />40.1 _,_ acres <br />an. n acres <br />_ 2 39i 44.00 - application fze <br />2 906A0 quarry application <br />_~193R_00 a n fee <br />_~2 344A0 conczrs7on fee <br />2. ~ --__.._lbsfl'onslx <br />Office of <br />Alive and Inactive Mines <br />