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P~rri~ <br />S~ ss <br />i'Ll - ~c~c~s -06( <br />STATE OF COLORADO <br />DNISION OF MINEWLS AND GEOLOGY <br />pepvonent of NaMnl Resourm <br />13135hdllun SL, ttaan ns ---,,,.~", ._. COLORADO <br />DPJIIIC, fblalado 80703 ~ DIVISION O F <br />t111a1e: (303) 8663s67 CONSTRUCTION MATERIAIS M I N FA RA L S <br />FAX: p03) 8328106 REGULAR (112) OPERATION AUG 18 2005 G 6 O L O G Y <br />RECLAMATION PE$MR'APPLICATTON FORM ee i.fFT1~iC MICE"~ <br />Oiviaion o(biinernlsli Geolo . <br />BXiowna <br />~„~. <br />CHECK ONF.: 'Ibere h ~ FOe Number Alrady AnipN to thh Opentbp r,...a ~~ <br />Permit # ~-_ _ _ (Please reference the 6k ntanher aarautly assigned to this operation) FuMlve oiraUar <br />x New Applicative (Rule 1.4.5) _ Amepdmmt AppGcetion (Rule 1.10) ~~ a <br />_ Copveniop Application (Rule I. I l) Naural Reuu~¢ rnmee <br />Permit # ~-~ -_ (provide for Anxpdmepb and Copveniope of existing permits) <br />The application for a Cvestructive Materials Regular 112 Operative Reclmnatiou Permit contains three majorpatu: (1) the applicative form; <br />(2) Exhibits A-S, Addcndtnn 1, etry sections ofExhibit 6.5 (Geotechpical Stability Exhibit; auld (3) the applicative fee. When yve submi[your <br />application, be sure [o ittclude we (1) complete simled mld notarized ORIGINAL end one (l) copy of the amlpkKOd appliratienfom4 two (2) <br />copies ofF.xhibits A-S, Addendlun 1, appropriate sections of6.5 (Georochlocal Stability Exhibit, and a check for the applicmiw foe described <br />under Sectiw (4)below. Exhibits should NOT be boupdmiDa3-ring border, maps should be folded to8l/2"X it"a8 i2"X 14"sue. To <br />expedite processing, please provide the ildormative in the format mud order' described in this form <br />GENERAI.OPERATION INFORMATTON <br />Type or prior clearly, in the 3paee pFOVlded., ALL hlformafbp tegaested below. / - <br />1. AopPaeantbceralor or company naPle (name to be ured ap permit): M ~t-~ene~e-~e ~onS ~ri~c Tioni_~e. <br />1. I Type of orgenizative (corporeDw, partnership, etc~~)1 Co ~o.-a do Co.,oara7r~o!7 <br />2. Ooenlion name foil. mine or site names: 2O KdO~ Grq ye/ P T <br />3. Permitted acreage (new or exlatine eile): ZG . 99 permitted saes <br />3.1 Change N aaeage (+) - ~ ' acres <br />3.2 Total acreage in Permit area ZG. 99 saes <br />4. Fcer: <br />4.I New App]icative $2344.00 applicative fee <br />4.2 New Quarty Application $2.906,00 gnmly applicative <br />4.4 Amendment Fee $1.938.00 amvdmalt fee <br />4.5 Cwversiw to 1 12 operative (set by alatute) / 52.344.011 convasiw fre <br />J. Prhparv eomupodhiefa) to be miaea: _ /`o/~ d L7ra/e/ e: / <br />5.1 Imridental commoditie(s) to be mined: t. _ Ibs/fons/vr z. / lbs/7'ves/vr <br />3. / lbs/foa4/yr 4. ! lirslfw S. / Ibs/fwshr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: Coll Sf/'UC ~iO/7 /(/lo far/ o ~ <br />5.3 Anticipated end use of incidental colprpalitie(s) io be mined: <br />Office of l3fFice of Colorado <br />Mined land ttedam+tion AOMe aM Inadlve Mina Geobgnl Survey <br />