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? <br />+ r <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />~E~~9~1!~D <br />t 313 Sherman SL, Room z1 s C O L D RA D O <br />Denver, Colorado 80203 CONSTRUCTION MATERIALS ~ APR 14 2004 D I v t s t o N o e <br />Phone: (303)8663567 MIN E RA L S <br />Flyifa~3~832~tQfa ®~ REGULAR (112) OPERATION ~ Givision of Minerals & GeoloBY G E O L O G Y <br />~+IL`Ft 1!1/'UU ~J RECLAMATION PERMIT APPLICA'T'ION FORM RFCIAMATION•MINING <br />/p~// SAFETY•S CIENCE <br />®~ ~~~~~i° ~ ~ Bill Owens <br />CHECK ONE: There is a Fik Number Already Assigned to this Operation eovemor <br />Permit # M -_ _ (Please reference the file number currerttl asst ed to this o erasion Gres E. wald,er <br />Y ~ P ) Executive Director <br />X New Applicatiou (Rule 1.4.5) _ Amendment Application (Rule 1.10) Ronan w. Caaany <br />Division DIEMOr <br />Conversion Appl~ictation (Ruk 1.11) NMUraI Resource Trustee <br />Permit # ~ Zook ~ 62 f (provide for Amendments and Converoiona ofexisting permits) <br />The application for a Construction Materials Regulaz 112 Operation Reclamation Petmit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, arty sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and {3) the application fee. When you submityour <br />application, be sure to include one (1) comQlgte aimed and notarized IVORY ORIGINAL and one (1) ewpy ofthe completed I~ application <br />form, two (2) copies ofExhibits A-S, Addendum 1, appropriate sections of6.5 (Geotechnical Stability Exhibit and a check for the application <br />fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder, maps should be folded to 8 t /2" X 1 t"or 8112" X <br />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, m the space provided, ALL information requested/belasr. <br />1. AnnlicanUoaerator orcomnaov name (name to be used on nermk): OTERO COUNTY " <br />l .l Type of organization (corporation, partnership, etc.): COUNTY GOVERNMENT <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: <br />2. Operation name (ok. mine or eke name): OTERO COUNTY - MENDENHALL PIT <br />3. Permitted acresee (new or eaistin¢ ake): NEW SITE <br />3.1 Change in acreage C+) <br />3.2 Total acreage in Permit area <br />4. Fces: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute} <br />5. Primary rnmmoditie(sl to be mined: SAND GRAVEL <br />5.1 Incidental commoditie(s) to be mined: i ,NONE _ Ibsl1'ons/t~ <br />3. / 1bsR'ons/vr 4. / 1bsR'onsh~ <br />724 permitted acres <br />acres <br />acres <br />$2.344.00 application fee <br />$2.906.00 quarry application <br />$1 938.00 amendment fee <br />$2344.00 conversion Tee <br />2. / lbs/fons/vr <br />5. / lbslfons/vr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: ROAD MATERIAL <br />5.3 Anticipated end trse of incidental conunoditie(s) to be mined: <br />STATE OF COLORADO <br />- - ~ Office of ice of Cofora <br />Mined Land Reclamation - Active and Inattive Mines Geological <br />