PERMFILE133197

• Permit No: M2000072
• IBM Index Class Name: Permit File
• Doc Date: 6/5/2001
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT 110 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

DIVISION OF MINEMlS AND GEOLOGY
(h}aurnxnl of Narural Resources
1 S 11 Sherman S{., Room 215
()cover. Cdorado 80?O3
Phnnc. 13031 864-3567
FAX: i:{I131 8i2-8106
~~iiii~~~iii~~~~iir
STATE OF COLORADO
RECEIVED
APR 0 6 2001
~I~
DEPARTMENT OF
1~lATURAL
RESOURCES
IT3~~o~~ H IC:®
Division of Mlnerale and Geology
JUG! 0 5 2001 *.'"rTm ~'~' cllo~ op;ss(r.Txoo(a
RECLi110~TiCa7 PE10!QT APIILICATZON PO1Rd
Division of Minerals and Geology
C!(ECK ONE: Y li~M Application (Rule 1.4) Conversion Application (Rule 1
Ro, w,mer
GG, !roar
Iamef 5. Lachhead
E.ecuave Dvenar
mi<haN B. ! onR
11) D~~ision Due[tur
Amendment Application (C.R.S. 34-32.5-110)
Permit i M - 2000-072 -_ (provide for )amendments and Conoeraioas of
existing permits)
The application for a Construction Materials Limited Impact (110) Operation Reclamation Permit
contains three major parts: (1} the application form; (2) Exhibits A-J, Exhibit L, Addendum 1,
any sections of Exhibit 6.5'and Geotechnical Stability Exhibit, as required by the Office, and
outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); and (3) the application fee. When you
submit your application, be sure to include one (1) complete sicred and notarized I90R7 OAZGIIOIL
and one (i) copy of the completed Ivorv application form, two (21 copies of Exhibits A-J,
Exhibi*_ L, Addendum 1, and appropria*_e sections of 6.5 (Geotechnical Stability Exhibit), as
required, and a check for the application fee described under (4) below. Exhibits should ice' be
bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" or 8 1/2" X 14" size. To
expedite processins, please provide the information in the format and order described in this
form.
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GENERAL. OPERATION INFORMATION
Typo or priest clearly, is the epaco provided, g-j~ iafornation described helot.
_. l~licaat/operator or compaav name foam! to be used oa pemitl:
1.1 Type of crganization (corporation, partnership, etc.): partner5hip_. _
1.2 I.R.S. Tax ID No. or Social Security Number:
:. 9~ration name (nit mine or Bite name}; H & II Trnckin
.,. Permit ted acreaoe (nay. or esietiaa sitel: 9•S pezmitted acres
3.1 Change in acreage (+; , _ _ __ _ acres
Total Acreage in Permit Area 9.5 aczes

4 . Il`ggrg:
4.1 New Applioation SB75.00 application fee
Amendment Fee (C.R.S. 34-32.5-125(ii1) 555.00 app'_icaticn fee
4.2 Conversion Eee (from 110d to 110 5875.00 conversion fee (Rule 1.11.2(211
5. Bra.mar v commoditie(s) to be unsd: top soil
5.1 Incidental commoditie(s) to be mined: 1. - ibs/Tor=/vr
2. / '~bs/Tons/vr 3. / lbs/Tons/vim
9. Lbs/To r.s/vr 5. ~ Ib=/Tor=/v-
5.2 Anticipated end use of primary commoditie(s) to be mined: lawns 8 gardens
5.3 Anticipated end use of incidental commoditie(s) to be alined: