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- ~,ovS- 003 r~ <br />CONSTRUCTION MATERIALS / <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />FLT ~: ~~",~ <br />0 Luu0 <br />7ivisien of i.9inerzls & Gaolepy <br />~~~~-VED <br />FEB 0 4 2005 / <br />CHECK ONE: X There is a File Number Already Assigned to this Operation Division of <br />Mincvals and lleolopy <br />Permit # ~--~r-='=r= (Please refeteree the file tuuNter cmcen[ly assigred to this operation) <br />X New Application (Rule 1.4.5) -Amendment Application (Rule I.10) <br />Conversion Application (Rule 1.11) <br />Pemrit # -A4-_:.~-~09T' -_ (provide for Amendments and Conversions of existing pemrits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Persrrit contains three major parts: (1) the application <br />form; (2) Exhibits A-S, Addendum 1, arty sections of Exhibit 6.5 (Geotechstical Stability Exhibit; and (3) the apphcation fee. When you <br />submit your application, be sate to ittclude one (1) complete signed and stotasized ORIGINAL and one (1) copy of the completed <br />application fomt, two (2) copies of Edtibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exlnbit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be board or in a 3-ring birder, maps should be folded to <br />8 1/2" X 11" or 8 1/2" X 14" size. To expedite processing, please provide the irffomtation in the format aid order described in this form. <br /> GENERAL OP112ATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br /> '~ <br />1. An nlicanUocerator or comoanv name [name to be used on cermit): Van Valkenbure Cattle. LLC. <br /> 1.1 Type of organisation (corporatioq pamrership, etc.): Corjwmtion <br /> 1.2 I.R.S. Tax I.D. No. or Social Security Number. <br />2. Op eration name (pit, mine or site name): VAN VALKEN$URG GRAVEL PIT <br />3. Permitted acreage (new or esistina site): 36 pesffitted acres <br /> 3.1 Change in acreage (+) acres <br /> 3.2 Total acreage in Pemri[ area 36 acres <br />4. ~: <br /> 4.1 New Application $2344.00 application fee <br /> 4.2 New Quarry Application $2.906.00 quarry application <br /> 4.4 Amerdnrerd Fee $1.938.00 amerdmeru fee <br /> 4.5 Conversion to 112 operation (set by statute) $2344.00 conversion fee <br />5. Primary commoditie(s) to be mined: SAND GRAVEL <br />5.1 IncideNal cormrroditie(s) to be awned: I. - Ibs/I'orrs/yr 2. ~- IbstPat~dy>-- <br />3. / Ibs/I'ors/v_r 4. / lbs/fon~/ R 5. / Ibs/fostslyr <br />5.2 ANicipated erd use of primary cotmtnditie(s) to be missed: Surface Ranch Roads/ Commodities for sale. <br />5.3 Astticipated end use of incidental commmdite(s) to be misted: <br />