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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 ?M . O 1 <br />Denver, Colorado COLORADO <br />. 03).66-IMICE'VED `• ` D IV I S I O N <br />Phone: 130318 OF <br />RECLAMATION <br />FAX: (303) 832-8106 CONSTRUCTION MATERIALS M I N I NG <br />AUG 15 2008 REGULAR (112) OPERATION - &- <br />ItECLAMATION PERMIT APPLICATION FORM SAFETY <br />Division of keciamation, <br />Mining and Safety Bill Ritter, Jr. <br />/ Governor <br />CIECK ONE: V There is a File Number Already Assigned to this Operation Harris D. Sherman <br />Executive Director <br />Permit # 1V1M- 00 -g (Please reference the file number currently assigned to this operati(4ald W. cattany <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Division Director <br />Natural Resource Trustee <br />-Conversion Application (Rule 1.11) <br />Permit # _ M (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed <br />application form, two (2) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to <br />8 1/2" 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. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />Applicant/operator or company name (name to be used on permit): C9n,ne lk % Sptx1•Le s <br />1.1 Type of organization (corporation, partnership, etc.): C 1) to no On _ <br />2. Operation name (pit, mine or site name): w h i'tc- N i VC r <br />3. Permitted acreaee (new or existine site): <br />3.1 Change in acreage (-+-) <br />3.2 Total acreage in Permit area <br />P?1? <br />4. Fees: <br />4.1 New Application <br />4.2 New Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Frippery connpoditie(s) to be mined: _50 ?_ ?1'avc? <br />5A Incidental commoditie(s) to be alined: I. _ _,_,_ lbsCFons/vr <br />3. I lbs/Tons/vr 4. <br />5.2 Anticipated end use of primarycommoditie(s) to be mined: _ <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: <br />U. -7 permitted acres <br /> acres <br /> acres <br />$2,696.00 application fee <br />$3,342.00 quarry application <br /> amendment fee <br />2696.00 conversion fee <br />2. / lbs/Tons/vr <br />5. lbs/Tons/vr <br />Office of Office of <br />Mined Land Reclamation Denver - Grand )unction - Durango Active and Inactive Mines