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-~~~oo~-D~{3 <br />. STATE OF COLORADO <br />• DIVISION OF MINERALS AND GEOLOGY <br />Depamnent of Natural Resources RECEIVE D <br />1313 Sherman St., Room 215 C O L D RA D O <br />Denver, Colorado 80203 CONSTRUCTION MATERIALS JUN i 0 2004 :~ DIVISION O F <br />Phone: (303) 8663567 MIN 6 RA L S <br />FAX: (3031832.8106 REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICA11~1W~li:~tnerals and Geology G E O L O G Y <br />0.FC LAM ATION•NINING <br />SAFETY•SCIENCE <br />Blll QVenS <br />CHECK ONE: There is a File Number Alresdy Assigned to Ibis Operation ewemur <br />Greg E. Walcfier <br />Permit # Ivy-= _ _ (Please reference the file number cttrrently assigned to this operation) Executive Director <br />/ New' Application (Rule I.4.5) _ Amendment Application (Buie 1.10) Ronaid w. Cattany <br />Conversion Application (R)ile 1.1 I) Division DInK[Or <br />Natural Resource Trustee <br />Pemtit # M -~ -_ (provide For Amendments and Converaans of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 65 (Geotechnical Stability Exhibit; and (3) the application fee. When you submityota <br />application, be sure to include one (1) complete sieved and notarized IVORY ORIGINAL and one (i) copy ofthe completed ~ application <br />forth, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (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 12" X I 1"or 812" X <br />14" size. To expedite processing, please provide the information in the format and order described in this fomr. <br />. GENERAL OPERATION INFORMATION <br />Type or prier ckerly, ie the space provided, ALL informatioo requested below. <br />I. Aoolicanttotxrator or comoaov name (name to be used on cermitl: 1Lf'I L C n ~ NG. <br />1.1 Type of orgattization (corporation, partnership, etc.): e 0 2P~2. A •rt pt.l <br />1.2 T.R.S. Tax I.D. No. of Social Security Number: 8~ '- O S 2 ~ $ $ ~ <br />2. Ooeratioe name (nit. mice or site name): V f~ L C~ T 4~ 1 T <br />3. Permitted screaae (new or etdatine site): <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to ] ]2 operation (set by statute) <br />5. Priman'rnmmoditiels)tobemined: N'D U(7PruGt.~ <br />5.1 Incidental commoditie(s) to be mined: 1. Ibs/T'ons/vr <br /> <br />3. / Ibs/I'ons/vr 4. /. lbs/fonslrr <br />5.2 Anticipated end nse of primary commoditie(s) to be mined: IZ6 ~ lYl t x (' oNG(Lrsr 6 /~ S~ j. AC..t T f3 FFSF <br />_ permitted acres <br />acres <br />32.1~~, ages <br />$2344.00 application fee <br />$2.906.00 quarry application <br />$1.938.00 amendment fee <br />$2344.00 conversion fee <br />2. ! Ibs/Tonsh7 <br />5. / Ibs/fons/vr <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />Office of <br />Mined land Reclamation <br />Office of <br />Active and Inactive Mines <br />Geological Survl_, <br />