PERMFILE117481

• Permit No: M2004053
• IBM Index Class Name: Permit File
• Doc Date: 9/13/2004
• Doc Name: Application
• From: Riveras Excavation
• To: DMG
• Media Type: D
• Archive: No

TATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
Department of Natural Resources
1313 Sherman St., Room 215
Denver, Colorado 80203
Phone: [phone]
FAX: [phone]
SEP 13 2004
Divi>ian afi Milserals & GeB1a0Y
CONSTRUCTION MATERIALS
LIMITED 11NPACT (110) OPERATION `~
RECLAMATION PERMIT APPLICATTON FORM
COLORADO
DIVISION OF
MINERALS
IGEOLOGYI
RECLANATION•MINING
SAFETY•SCIENCE
Bill Owens
Governor
Russell George
Executive Director
Ronald W. Caaany
Division Director
CHECK ONE: There i8 a Fik Number Already Assigned to tltia Operation Nature) Resource Tnlstee
Permit # M _ZOtS~_~3 (Please reference the fde number cturently assigned to this operation)
,~ New Application (Rule 1.4.5)
Amendment Application (Rule 1.10)
Convesion Application (Rule 1.11)
Permit # , Irv _-_ -~ (provide for Amendments and Convenione of eadsting pemuts)
The application foraConstntctionMaterialsLimitedlmpact(110)OperationReclemationPermitcontainstlneelnajorparts: (1)theappliceti~
forth; (2) Exhbits A-J, Exhibit L, Addendum 1, any sections of Exhibit 6.5 and Geotechnical Stability Ex]ibit, as required by the Office, and
outlined in kules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1 xb); and (3) the application fee. When you submit your application, be sure to include one
(1) camglett: signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies of Exhibits A-J, Exlnbit L,
Addendum 1, and appropriate sections of 6.5 (Geotechnical Stabitiry Exhibit), as required, and a check for the application fee described under
(4) below. Exhibits should ~ be bound or in a 3-ring binder, maps should be folded to 8 1P2" X 11" or 8 1!2" X 14" size. To expedite
processing please provide the information in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or print clearly, In the apace provided, ALL Information described below.
1. ADDlicant/operator or company name (name to be used on Prrmit): ~l tic YY(~ ,~iG LP AU >a ~ ! (~ r1 r/
1.1 Type of organization (corporation, Partnership, etcJ: . ~ ~Q_= pY~b h! E ~y f-
1.2 LR.S. Tex ID No. or Social Security Number: S ~ S- 9Co - All / g
2. Of ration name (pit. mine or site same): ~/ I/7~YYt S ~rlL,4 L sr~/y>I l o it R I/~L- ~~~~-'
3. e~rrttted acrease (new or e=istina sfte): 9 ° ~ permitted acres
3.1 Change in acreage (+) acres
3.2 Total Acreage in Permit Area ~ ~ acres
4. ~:
4.1 New Application: $1 094. application fee
AmendmentFce(C.R.S.34-32.5-125(II)): $719. applicaionfce
4.2 Conversion Fee (from I I Od to 110 75.00 conversion fee (Rule 1.11.2(2))
5, Primary commodltie(al to be mined: ~!7?UeL
5. ] Iacideatai commoditie(s) to be mined: ],/QL~ Ibs/~'orls/vr 2. / lbs/forL"/vr 3. / 1bs/fons/vr
4. / lbs/Tons/vr 5. / 1bslTonsl~ ,~--77
5.2 Anticipated end use of primary commoditie(s) to be mined: ~sf er, n;3fo,.e ~ !YO 4 d ~ (t f ~ d f t.tq
Anticipated end use of incidental commoditie(s) to be mined: ~0 ~ ~,
Office of Office of Colorado
Mined Land Reclamation Active and Inactive Mines Geological Survey