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STATE OF COLORADO <br />/ <br />~' ~ DIVISION OF QECLAMATiON, MINING AND SAFETY <br />, <br />DepallmtM of *iatural Resources <br />~~©~ " 1N- <br />215 Q <br />St <br />R <br />~ <br />~ <br />.. <br />oom <br />1313 Sherman <br />~/ <br />~ C O L O R A D O <br />Denvcr, Colorado 80103 O I v! S I O N O f <br />I+Imlle: t3o1) %63567 <br />/ RECLAMATION <br />FAX: (303) 8328106 M 1 N I NG <br />_7 <br />-~ ~ ~ <br />~ D~ ~ E <br />/ SAF <br />TY <br />CONSTRUCTION 1NATERIALS <br />' / <br />I/ LI:HI7'ED L~iPACT (110) OPERATION sal °""~" <br />c~„e, <br />RF,CLAhiATION PERMT APPLICATION FORK a":Rn c~,rg <br /> Ezeartive IXstau <br /> xonald W. CAtany <br />CHECK ONE: There is a File Number Already Assigned to this Opvation D1YS6n o" `'°O1 <br /> Naoxal Itew,wte rns4e <br />Permit N M -_-~ _ (Please reference the file number ctntendy assigned to this operation) <br />New Application (Rule 1.4.5) Amendment Application (Rvk 1.10) <br />Converaioo Application (Rule 1.11) <br />Permit ft H -~ (provide for Amendmrnh and Conveniom of existing petrnits) <br />The application for a Coarstruction Materials Limited Impact (110) Operation Reclamation Pemtit contains three ttmjor parts: (I) the <br />application forrq (2) Exhbits A-1, Exhibit 4 AddetXlim t, any sectiottc of Exhibit 6.5 a~ Geotechnical Stability Exhibit, as required <br />by the Oftice. and outlined m Rules 6.1, 6.2, 63, 6.5, sad 1.62(1 xb): and (3) the appltcation fee. Wlxmm you suhamt yourapptication, be <br />sure to inchtde one (I) corttolete si®ed and notarized ORIGINAL and om (1) copy oftlx corttpleted application form, two (2) copies <br />of Exhibits A-1, Exhibit L, Addendum 1, aril appropriate secriom of 6.5 (Geotechnical Stability Exhibit), as required, and a check for <br />the application fee desmbtd utlder (4) below. Exhibits should NOT be bound or in a 3-ring binder; amps alwildbe folded to g 1/2" X <br />I l" a g t/2" X (4" size. To expedite processing, please provide the infommlion in the format and order desrnbed in this form <br />GENERAI.OPERATION INFORMATION <br />Type or print clearly, iu the space provided, ALL Informatfoo dtxeribed below. <br />I.i Type of orgattirrtion(cotporadon,partrership,eteJ: GO/~or2r!'to"I _ <br />2. i)oeration mrne (oiL mine or site morel: M2.r~-f /t~~. <br />3. Pf~ttrd aerea¢e (new or exittim aural: 9.9 permitted scree <br />3.1 Change in acreage (+) ~/4 acres <br />3.2 'total Acreage in Permit Area ~_'~ ~~ ~ e 1' ~ r "~,/ _ 9 ' 9 acres <br />4. Fen: ,~ <br />4.1 Vew Application: F `~. ~ ~ ~ ~r~~ ~1 094.00 application fee <br />Amendmeta Fee (C-R.S. 34-12.5-125(11)): C~. ~ ~- - ~:~..Cin, _ 73 19.00 application fee <br />4.2 Coiversion Fee (from 1 IOd to 110 875.00 conversion fee(RUla7:4 H.2(2y1 <br />5. Primarvcomntoditie/sltobemiced:8o1~~~¢r5~~ rock <br />S.l Incidental cormnoditic(sj to be mined: 1. Ibs/TOaw'vr 2 !_ Ibs•Tons/vr 3. _ ! Ibsrl'ons%vr <br />4. / IbarTorlslvr <br />5.2 Mticipaled end use of primary coltmwditie(s) to be mined: <br />Mticipated end use of ituidenWl cormrmditie(s) m lx mined: <br />Otfxx of <br />Mined land Reclamatim <br />5. / Ibs~TOro/vr <br />L2n~ccQa'l~inG .Eros;oil Co.r+ro~ <br />!~-..ds-G~ i1'~Gi <br />O(fice of <br />Alive and IlucYive Mines <br />