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411, <br />C/VD / <br />STATE OF COLORADO <br />DIVISION OF RECLAMATION, M€N€NG AND SAFETY <br />Department of Natural Resources _ <br />1 3 1 3 Sherman St., Room 215 J q C O L O R. A D O <br />Denver, Colorado 80203 44 diVi ®?? t' ? t t v l s r o OF <br />Phone: (303; 866-356: Sign Qf li0i???tiO RECLAMATION <br />FAX: (303, 83z?106 CONSTRUCTION 1MATER ALS Mining and Saf6Qy n ,tin I t?T l G <br />REGULAR (112) OPERATION <br />RECI.AA- :TION PERNMIT A-PPL.ICATION FORM SAFETY <br />Bill P.itter, Ir. <br />Guver or <br />CHECK ONE: There is a File Number Already Assigned to this Operation Harris D. Sherman <br />Executive Director <br />Permit ## lei (Please reference the file number currently assigned to this operati . ld w. Cattanv <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) Division Director <br />Natural Resource Trustee <br />_ Conversion Application (Rule 1.1 1) <br />Permit ## .1 = _Lg96-jL?Z__- (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 S 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />GENEIUkL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALI, information requestedAelow. <br />] . Applicant/operator or company name (name to be used on permit): ??QK '0Uit/Ty .?- /3' R iNse <br />1.1 Type of organization (corporation, partnership, etc.): <br />a? <br />i61 /T <br />2. Operation name (pit, mine or site name): Alj <br />3. Permitted acreage (new or existine site): <br />3.1 Change in acreage (-I-) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application <br />4.2 Nvv Quarry Application <br />4.4 Amendment Fee <br />4.5 Conversion to 112 operation (set by stab=.e) <br />5. Priman, commoditie(s)- to he mined: ,epd?66- <br />5.1 Incidental commoditie(s) to be mined: i. -5D0 lbs/Tons/y-r <br />?. 9 permitted acres <br />:5_-3 acres <br />?15, 2 acres <br />$2,696.00 application fee <br />S3,342.0(i quam, application <br />52.229.00 amendment fee <br />$2,696.€ 0 conversion fec <br />Z lbsiTolns/vr <br />3. Ibs/Tonsf` T 4. Ibs;Tons yr 5. ?,-_-_- l.bs(fons/yr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: 04b <br />5,3 Anticipated end use of incidental. commoditie(s) to be mined: <br />Office of Office of <br />Mined Land Reclamation Denver • Grand )unction a Durango Active and Inactive !Mines