Laserfiche WebLink
_~ <br /> <br />CONSTRUCTION MATERIALS ~AY ~ Z ZCOg <br />v <br />LIMITED IMPACT (110) OPERATION tlivi-iar. ct f ~; :'ss'. ~ ~~ <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: X There is a File Number Iready Assigned to this Operation <br />Permit # M - 2000 -018 (Please reference the file tnunber currently assigned to this operation) <br />New Application (Rule 1.4.5) X Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M - 200.0 _ Ol B (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit contains three major parts: (1) the <br />application form; (2) Exhibits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Exhibit, as required by <br />the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be sure <br />to include one (1) complete sieved and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies of <br />Exhibits A-J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the <br />application fee described under (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11 " or 8 <br />I/2" X 14" size. To expedite processing, please provide the information in the format and order described in [his form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information described below. <br />1. AHUlicantlooerator or comnanvname (name to be used on Hermit]: Che enne County <br />1.1 Type of organization (corporn[ion, parfiership, etc.): County Government <br />1.2 I.R.S. Tax ID No. or Social Security Number: <br />2. Operation name (Hit, mine or site name]: Munsch Pit <br />3. Permitted acreage (new or existine site): ~ • 5 permitted acres <br />3.1 Change in acreage (+) 2 acres <br />3.2 Total Acreage in Permit Area 9.5 acres <br />4. Fees: <br />4.1 New Application: $1.094.00 application fee <br />Amendment Fee (C.R.S. 34-32.5-125QI)): 719.00 application fee <br />4.2 Conversion Feo (from 1 lOd to 110 875.00 conversion fee (Rule 1.11.2(2)) <br />5. Primary commoditie(s) to be mined: Sand Gravel <br />5.1 Incidental commoditie(s) to be mined: L / 165/Cons/vr 2. / Ibs/I'ons/vr 3. / Ibs/Tons/vr <br />4. / Ibs/Tons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: <br />Anticipated end use of incidental commoditie(s) to be mined: <br />5. / Ibs/fons/vr <br />Sand & Gravel to be spread on cnty rds. <br />N/A <br />