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<br />DIVISION OF htINERAlS AND GEOLOGY <br />I)rpdrrnn~nl rn N.11ur.~l Resources <br />I ; 14 lhermdn R.. Ruum ! l i <br />[,tti Iw;l+4ualu„ <br /> <br />CONSTRUCTION MATERIALS <br />R~cErv~c <br />APR ~ 5 1999 <br />gYi/i11f1 of AfillEfalS 8 GeobGY <br />L~~ <br />D I V I S I J rv O F <br />MINERALS, <br />GEOLOGY; <br />REC iA MA710N <br />MINING•SAFE 7Y <br /> <br />LIMITED. IMPACT (l10) OPERATION Rill pwem <br />fnvernur <br />RECLAMATION PERMIT APPLICATION FORM ere E. wal, net <br />Eaeculrve D"C~lur <br /> mich.rl tl. LunG <br /> Dm~ann Di¢vnr <br />CHECK ONE: X New Application (Rule I.4) Conversion Application (Rule I.I l ) <br />Amendment Application (C.R.S. 34-32.5-1 IO) <br />Permit 8 M -_ _ _ (provide for Amendments and Conversions of existing permits) <br />The application for a Conswction Mazerials Limited Impact (I 10) Operation Reclamation Permit contains three major parts: (l) the application form; <br />(?)Exhibits A-J, Exhibit L, Addendum 1, any sections ofExhibit 6.5 and Geotechnical Stability Exhibit, as required by the Office, and outlined in Rules <br />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 to include one (l) comolete signed and <br />notarized IVORY ORICDVAL and one (I) copy ofthe completed [vim application form, two (2) copies of Exhibits A-J, Exhibit L, Addendum 1, and <br />appropriate sections of6.5 (Geotechttiral Stability Exhibit), as requved, and a check for the application fee described under (4) below. Exhibits should <br />NOT be bound or in a 3-ring binder, maps should be folded to 8 l2" X 11" or 8 l2" X l4" size. To expedite processing, please provide the information <br />in the format and order described in this farm. <br />ATE OF COLORADO <br />GENERAL OPERATION INFORMATION (Y1-99- Del 3 <br />Type or print clearly, in the space provided, ALL information described below. <br />AoolicanUooerator or comoanv name (Dame to be used on permit): L i nco 1 n Count <br />1.1 Type of organization (corporation, partnership, etc.): <br />l1 I.R.S. Tax ID No. or Social Security Number: 781 <br />2. Operation name foit, mine or site name): <br />C ~ D Farms No. 2 <br />3. Permitted acresee (new or e:istine site): permitted acres <br />3.1 Change in acreage (+) acres <br />Total Acreage in Permit Area 8 • 7 acres <br />4. Fees: <br />4.1 New Application: 5875.00 application fee <br />Amendment Fee (C.R.S. 34-32.5-125(II)): 5575.00 application fee <br />41 Conversion Fee (from I I Od to I l0 875.00 conversion fee (Rule I.I I.?(?)) <br />5. P-imtrvcommoditie(sltobemined: Sand r Gravel <br />5.1 Incidental commoditie(s) to be mined: I. none/ Ibs~fons/vr '?. / Ibs/Tons/vr 3. / Ibslfans/vr <br />4. / Ibslfons/vr 5. / Ibsrfons/vr <br />5.? Anricipa[edenduseofprimarycommodirie(s)tobemined: Road Maintenance <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: none <br />