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Home My WebLink About20130693.tiffpo�c� L3Of nmli tEmdilEg9 D PO Box 609 Pine Bluffs, WY 82082 May 31, 2013 Division of Reclamation, Mining & Safety 1313 Sherman St., Room 215 Denver, CO 80203 RECEIVED JUN 0 6 2i)1:i COMMISSIIONERS RE: Pine Bluffs Gravel & Excavating, Inc., Harms Pit, Fiie No. M-2013-018 110c Permit Application Dear Mr. Hays, Below are our responses to your letter dated May 30, 2013. 1) A copy of the Affadavit of Publication was mailed to your office via certified mail on May 30, 2013 2) A copy of the Affadavit of Mailing to Janyce Harms was mailed to your office via certified mail on May 30, 2013. This confirms that a copy cf the Affidavit of Publication was mailed to Janyce Harms on May 30, 2013. A copy of the return receipt is enclosed. 3) We have reveiwed the letters from History Colorado and the Army Corps of Engineers. We acknowledge State Law CRS 24-80 and agree to follow those laws in the event that human remains are found. We also acknowledge the letter from the Army Corps of Engineers that we will obtain any other applicable permits. 4) The updated map and Exhibit A enclosed. 5) The updated map and Exhibit A enclosed. 6) We will be considered an intermittent operation according to C.R.S. 34-32.5-103(11)(b). 7) Depth of soil used in the reclamation process will be 6 inches deep. 8) Topsoil will be stockpiled directly adjacent to and within the mined area. 9) The gravel operation will be considered a "dry" operation and maintain a minimum of two (2) feet above the groundwater elevation. 10) We will have a vertical highwall so backfi.11ing will be required to get to the final 3H:1V grade. 215 Main St., Suite A Pine Bluffs, WY 82082 Phone - 307-245-3676 ax - 307-245-3748 Lewd - LOCATIONS - 114 S. Riverbend Douglas, WY 82633 Phone — 307-358-5123 Fax — 307-358-0970 c&3- Do°(5 j gm EMU§ OTNg! REEN'arilgp PO Box 609 Pine Bluffs, WY 82082 11) Please see updated Exhibit F that is enclosed with this letter showing our commitment to obtain a Stormwater Management Plan permit from the Colorado Deppartuient of Public Health and Environment. 12) Overburden will be replaced to a depth of 6 inches ,::s recommended by the Division. 13) Reclaimed slopes will not be steeper than 3H:1V as recommended by the Division. 14) Topsoil will be replaced to a depth of 6 inches as recommended by the Division during the reclamation process. 15) We agree to spray any noxious weeds that are encountered during the mining or reclamation process. To date, we are not aware of any noxious weeds within the proposed mining area. Our contact at the Weld County Weed Division is Tina Booton (970) 304-6496 x3770. a. Target Species — Noxious weeds that may be found in the proposed mine according to the Weld County Weed Division are Canada Thistle, Diffuse Knapweed and Bindweed. "Junk" weeds that may be found are kochia, sunflower, bull thistle. b. According to the Weld County Weed Division we will need to spray the above listed noxious weeds in the spring or fall, before or during the roset stage with Milestone or Tordon and a non-ionic surfactant. Milestone will need to be applied at 7 oz per acre. A licensed sprayer would apply Tordon at 32 oz per acre. The Weld County Weed Division also recommends adding 2-4-D if the weeds are very tall. Regular mowing would control any other "junk" type weeds. c. The on -site Gravel Pit manager would be responsible for monitoring growth of noxious and junk weeds. He would then arrange for spraying or mowing of such weeds. 16) Recommended seed mixture in pounds per acre according to the NRCS — Will @ 970-356-8097. a. Switchgrass - .4 PLS/acre b. Sideoats grama - .9 PLS/acre c. Little bluestem - .7 PLS/acre d. Green needlegrass — 1.0 PLS/acre e. Blue grama - .3 PLS/acre 215 Main St., Suite A Pine Bluffs, WY 82082 Phone - 307-245-3676 Fax - 307-245-3748 LOCAL i ICj,S y 114 S. Riverbend Douglas, WY 82633 Phone — 307-358-5123 Fax — 307-358-0970 Hrin lElu0 LammO�l�J9 PO Box 609 Pine Bluffs, WY 82082 17) Acknowledged 18) Acknowledged 19) Replaced overburden and topsoil will be placed ta? depth of 6 inches. 20) Affidavit of mailing to the Weld County Clerk is enclosed. If you have any questions, please call me at (307) 245-3676 or on my cell phone at (307) 630-9650. Sincerely, Doug Keller Pine Bluffs Gravel & Excavating, Inc. Enclosures — Legal Description and Location Maps, Exhibit A, Janyce Harms return receipt, updated Exhibit F, Affidavit of mailing to Weld County Clerk 215 Main St., Suite A Pine Bluffs, WY 82082 Phone - 307-245-3676 Fax - 307-245-3748 - LOCATIONS '~ 114 S. Riverbend Douglas, WY 82633 Phone — 307-358-5123 Fax — 307-358-0970 EXHIBIT A: Legal Description and Location Map (1) Legal Description: a) The proposed site for the gravel pit is located at Section 34, Township 11 North, Range 58 West of the 6th P.M., Weld County, Colorado, more particularly described as: A tract of being the a portion of the Southeast Quarter (SE1/4) of Section 34, Township 11 North, Range 58 West of the stn P.M., Weld County, Colorado, more particularly described as follows: Beginning at a point from which the east quarter corner of said Section 34 bears N.60°18'04"E., a distance of 1395.94 feet (when considering the east line of the NE1/4 of Section 34 bears N.00°28'31"W); thence S.00°00'00"E, a distance of 434.73 feet; thence N.90°00'00"W, a distance 1000.00 feet; thence N.90°00'00"E, a distance of 1000.00 feet to the point of beginning. Containing 9.98 acres, more or less, and subject to easements, covenants and restrictions of record. Together with an easement for ingress and egress purposes, said easement being 60 feet wide and centered upon the following centerline: Beginning at a point on the north line of the above described parcel, from which the northwest corner thereof bears N.90°00'00"W, a distance of 416.74 feet; thence N.01°52'52"W, a distance of 562.42 feet; thence N.50°39'24"W.,a distance of 96.15 feet; thence S.88°11'30"W, a distance of 684.18 feet; thence N.77°37'52"W., a distance of 194.38 feet; thence N.14°15'06"E, a distance of 132.99 feet; thence N.02°26'03"E, a distance of 1385.29 feet; thence N. 26°26'41"W., a distance of 679.12 feet; thence N.39°31'55"W., a distance of 253.07 feet; thence N.69°03'54"W., a distance of 284.24 feet; thence 582°33'15"W., a distance of 427.76 feet; thence S. 81°14'42"W., a distance of 293.18 feet; thence N.71°16'03"W., a distance of 348.87 feet; thence N.80°42'32"W., a distance of 795.45 feet; thence N.39°48'22"W., for a distance of 82.13 feet to the intersection of County Road 124 and County Road 127 and said easement there terminates. See attached map. (2) The main entrance to the mine site based on a USES Topographic Map with specific coordinates of latitude and longitude in degrees, minutes and seconds: Beginning at a point on the north line of the above described parcel, from which the northwest corner thereof bears N.90°00'00"W, a distance of 416.74 feet; thence N.01°52'52"W, a distance of 562.42 feet; thence N.50°39'24"W.,a distance of 96.15 feet; thence S.88°11'30"W, a distance of 684.18 feet; thence N.77°37'52"W., a distance of 194.38 feet; thence N.14°15'06"E, a distance of 132.99 feet; thence N.02°26'03"E, a distance of 1385.29 feet; thence N. 26°26'41"W., a distance of 679.12 feet; thence ►x.39°31'55"W., a distance of 253.07 feet; thence N.69°03'54"W., a distance of 284.24 feet; thence S82°33'15"W., a distance of 427.76 feet; thence S. 81°14'42"W., a distance of 293.18 feet; thence N.71°16'03"W., a distance of 348.87 feet; thence N.80°42'32"W., a distance of 795.45 feet; thence N.39°48'22"W., for a distance of 82.13 feet to the intersection of County Road 124 and County Road 127 and said easement there terminates. See attached map. (3) A map showing information to determine the location of the affected land on the ground and existing and proposed roads or access routes to be used in connection with the mining operation, including the names of the immediately adjacent surface owners of record. (see attached) Weld County Roads 124 and 127 will be used for transportation to and from gravel pit. The names of the immediately adjacent surface owners of record include: Janyce Harms, See attached map. gl Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery Is desired. ® Print your name and address on the reverse so that we can return the card to you. R Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: C,? „z i r. 'gr `. s w T fates <! PLErF TIi ,pSi=C1IQAl QN DEL1 ER A. Signature B cfteceived by (Printed Name) C. D D. is delivery address different from item 1? 0 Yes If YES, enter delivery address below: 0 No 0 Agent Addressee Cer4ificd Mail 0 Express D Registered 0 Return Receipt for Merchandise 0 Insured Mail lJ O.O.Q. .. . 4. Restricted Delivery (Bdr Fee) 0 Yes 2. Article Number (Transfer from service lab 7011 2970 01102 4120 9081 PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 EXHIBIT F: List of Other Permits and Licenses Required 1. Air Pollutant Emission Notice (APED) and Application for Construction Permit And Fugitive Particulate Emissions Control Plan. 2. Access Permit Application for all points of ingress and egress onto County maintained roadways. 3. Colorado State Historical Preservation Office clearance (We have been informed that if there is no federal nexus for this project, but there is oversight from the Colorado Division of Reclamation Mining Safety (DRMS), that DRMS normally contacts the Colorado State Historical Preservation Office during the application review). 4. The proposed site for the gravel permit will be a dry pit and is far from a natural river, thence the ground water table should not be encountered by the operation. The mining operation will not expose any groundwater. There will not be any pollutants discharged into any State waters. 5. The proposed gravel site is not located on any federal lands or U.S. Forest Service. 6. Weld County Colorado Planning does not permit Section 110 Permits. Proof of evidence of the State permit will be submitted to the Planning office for their files. 7. Stormwater Management Plan permit from the Colorado Department of Public Health and Environment. 8. Any other permit that would be required that we have not identified at this time. AFFIDAVIT OF MAILING In the Matter of the Limited Impact (110) Operation Reclamation Permit Application State of Wyoming County of Laramie ) ss. Doug Keller, of Pine Bluffs Gravel & Excavating, Inc., being duly sworn, deposes and says: That he is over the age of eighteen years; That on L.., • , 2013, by regular first class and/or certified mail properly enclosed in a sealed envelope with the prepaid postage thereon, he deposited in the United States mail, at 115 W. 4th Street, Pine Bluffs, WY, 82042, notices, a true and correct copy of the Revised Application of the Construction Materials Limited Impact (110) Operation Reclamation Permit Application Form, address to the following: Weld County Clerk/Recorder 1402 N 17th Avenue Greeley, CO 80631 The receipts for certification of said letters are hereunto annexed and made a part hereof. I certify that the foregoing is true and correct. Dated this day of \L ,2013. Doug Keller, Project Manager Affiant STATE OF COLORADO Office of Mined Land Reclamation DIVISION OF RECLAMATION, MINING AND SAFETY Department of Natural Resources 1313 Sherman St., Room 215 Denver, Colorado 80203 Phone: (303) 866-3567 FAX: (303) 832-8106 May 14, 2013 Weld County Commissioners County Commissioner 915 10th St Greeley, CO 80631 RECEIVED NAY 172013 M!ssloe R COLORADO DIVISION OF RECLAMATION MINING — &— SAFETY John W. Hickenlooper Governor Mike King Executive Director Loretta E. Pineda Director RE: Notice of 110 Construction MaterialsReclamation Permit Application Consideration Pine Bluffs Gravel & Excavating, Inc., Harms Pit, File No. M-2013-018 Please be advised that on May 13, 2013, Pine Bluffs Gravel & Excavating, Inc., whose address and telephone number are 215 Main Street P.O. Box 609, Pine Bluffs, WY 82042; (307) 245-3426, filed an application to conduct Surface extraction of construction materials and reclamation, at or near Section 34, Township 11N, Range 58W, 06th Prime Meridian, in Weld County. Please be advised that the permit area may be located in more than one Section, Township, and Range. The application decision is scheduled for June 12, 2013. A copy of the application is available for review, unless you receive a CD, at the Weld County Clerk & Recorder's office and at the office of the Division of Reclamation, Mining and Safety, Room 215, 1313 Sherman Street, Denver, Colorado 80203. If you desire to make comments or objections of the mine plan and/or the reclamation plan, they must be submitted within ten (10) days of the date of the newspaper public notice to be considered in the application review process by the Division. You should contact the applicant for the newspaper publication date. If we do not receive your comments or any objection by the end of the public comment period, the Office will assume you have no objection or comment to the proposed activity. If you have any questions, please contact me. Sincerely, 9011 begfreen/ ifOr Peter S. Hays Environmental Protection Specialist doi3 ' ble9 3 Office of Denver • Grand Junction • Durango Active and Inactive Mines STATE OF COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY Department of Natural Resources 1313 Sherman St., Room 215 Denver. Colorado 80203 Phone. (303) 866-3567 FAX: (303) 832.8106 CONSTRUCTION MATERIALS LIMITED IMPACT (110) OPERATION RECLAMATION PERMIT APPLICATION FORM COLORADO DIVISION OF RECLAMATION MINING —&— SAfETY CHECK ONE: There is a File Number Already Assigned to this Operation Permit # 1 t3 018 (Please reference the file number currently assigned to this operation) i ✓ . New Application (Rule 1.4.5) t Amendment Application (Rule 1.10) Conversion Application (Rule 1.11) Permit # M - 2013 018 _ (provide for Amendments and Conversions of existing permits) The application for a Construction Materials Limited Impact (1 10) 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 (l) complete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies of Exhibits A -J, Exhibit L, Addendum I, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the application fee described under (4) below. Exhibits should NOT 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 processing, please provide the information in the format and order described in this form. GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, ALL information described below. 1. Applicant/operator or company name (name to be used on permit): Pine Bluffs Gravel & Excavating, Inc 1.1 Type of organization (corporation, partnership, etc.): Corporation 2. Operation name (pit, mine or site name),: Harms Pit 3. Permitted acreage (new or existing site): 3.1 3.2 4. Fees: 4.1 Change in acreage (+) Total Acreage in Permit Area New Application: Amendment Fee (C.R.S. 34-32.5-125(II)): RECEIVED APR O 1 2013 Division of Reclamation, Mining & Safety 9.98 permitted acres acres acres $1258.00 application fee $827.00 application fee 5. Primary commoditie(s) to be mined: sand gravel rock dirt 5.1 Incidental commoditie(s) to be mined: 1. / lbs/Tons/yr 2. / Ibs/Tons/vr 3. / lbs/Tons/vr 4. / Ibs/Tons/vr 5. / lbs/Tons/yr 5.2 Anticipated end use of primary commodities) to be mined: Anticipated end use of incidental commoditie(s) to be mined: aggregate materials for road projects for US Government -2- 11. Corresnondence Information: APPLICANT/OPERATOR (name, address, and phone of name to be used on permit) Tyler E. Kimzey Contact's Name: Company Name: Street/P.O. Box: City: State: Telephone Number: Fax Number: PERMITTING CONTACT Contact's Name: Company Name: Street/P.O. Box: City: State: Telephone Number: Fax Number: INSPECTION CONTACT Contact's Name: Company Name: Street/P.O. Box: City: State: Telephone Number: Fax Number: Pine Bluffs Gravel & Excavating, Inc. 215 Main Street Pine Bluffs Title: President P.O. Box: PO Box 609 WY (307 ) _ 245-3426 f 30 ) _ 245-3748 (if different from applicant/operator above) Doug Keller Pine Bluffs Gravel & Excavating, Inc. Zip Code: 82082 Title: Project Manager 215 Main Street Pine Bluffs P.O. Box: PO Box 609 WY (307 ) _ 245-3426 (307 ) _ 245-3748 Doug Keller Pine Bluffs Gravel & Excavating, Inc. Zip Code: 82082 Title: Project Manager 215 Main Street Pine Bluffs P.O. Box: PO Box 609 WY (307 ) _ 245-3426 (307 ) _ 245-3748 CC: STATE OR FEDERAL LANDOWNER (if any) Agency: Street: City: State: Zip Code: 82082 Zip Code: Telephone Number: ( ) - CC: STATE OR FEDERAL LANDOWNER (if any) Agency: Street: City: State: Zip Code: Telephone Number: ( ) - e -3- 7. 8. 9. Type of mining operation: ✓ Surface I I Underground 10. Location information: Name of owner of the subsurface rights of affected land: Janyce Harms Name of owner of the surface of affected land: Janyce Harms The center of the area where the majority of mining will occur: COUNTY: Weld PRINCIPAL MERIDIAN (check one): SECTION (write number): TOWNSHIP (write number and check direction): RANGE (write number and check direction): QUARTER SECTION (check one): QUARTER/QUARTER SECTION (check one): In -situ 6th (Colorado) ❑ 10th (New Mexico) S 34 T 11.0 North R 58.0 El East l l NW NW NE ✓❑ NE E South West SE ❑ SE Ute SW GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the approximate elevation): 20 miles east of Grover, CO; 22 miles north of New Raymer; approx. 5260 ft. elevation 11. Primary Mine Entrance Location (report in either Latitude/Longitude OR UTM): Latitude/Longitude: Example: (N) 39° 44' 12.98" (W) 104° 59' 3.87" Latitude (N): deg 40 min 53 sec 20 70 Longitude (W): deg 103 min 51 sec 38 .49. OR Example: (N) 39.73691° (W) -104.98449° Latitude (N) 40 Longitude(W) 103 - 86069 OR Universal Tranverse MercatorIUTM) Example: 201336.3 E NAD27 Zone 13 4398351.2 N .88908 (5 decimal places) (5 decimal places) UTM Datum (specify NAD27, NAD83 or WGS 84) _ NAD83 Easting Northing (2 decimal places) (2 decimal places) 13 Zone 4 -4- 12. Pri ary future (Post-mininel land use (thee enf ✓ Cropland(CR) Rangeland(RL) Residential(RSl ._,.. _.„,,/ — 1 ! Developed Water Resources(WR) is Pastureland(PL) Forestry(FR) Recreation(RC) 13. Prim resent land use (check one): LJ Cropland(CR) El Pastureland(PL) Rangeland(RL) Forestry(FR) Residential(RS) l iRecreation(RC) Developed Water Resources (WR) General Agriculture(GA) Wildlife Habitat(WL) Industrial/Commercial(IC) Solid Waste Disposal(WD) ElGeneral Agriculture(GA) L ' Wildlife Habitat(WL) RIndustrial/Commercial(IC) Mining (MN) 14. If this operation will use designated chemicals, or will result, or presently has acid mine drainage - you cannot use this application form. You must submit either a 110d or 112d application form for Designated Mining Operations. In either case, you must list any acidic or toxic -forming materials, exposed or disturbed as a result of the mining operation, and whether the operation will result in or presently has acid mine drainage: None 15. Description of Amendment or Conversion: If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s): Maps & Exhibits: Submit two (2) complete, unbound copies of the following application exhibits: 6.3.1 EXHIBIT A - Legal Description and Location Map 6.3.2 EXHIBIT B - Site Description 6.3.3 EXHIBIT C - Mining Plan 6.3.4 EXHIBIT D - Reclamation Plan 6.3.5 EXHIBIT E - Maps, to include the location of any recorded easements 6.3.6 EXHIBIT F - List of Other Permits and Licenses Required 6.3.7 EXHIBIT G - Source of Legal Right -to -Enter 6.3.8 EXHIBIT H - Municipalities Within a Two-mile Radius 6.3.9 EXHIBIT I - Proof of Filing with County Clerk 6.3.10 EXHIBIT J - Proof of Mailing Notices of Permit Application 6.3.12 EXHIBIT L - Permanent Man -Made Structures 1.6.2(1)(b) ADDENDUM 1 - Notice Requirements (sample enclosed) 6.5 Geotechnical Stability Exhibit (as required) -5 - Responsibilities as a Permittee: Upon application approval and permit issuance, this application becomes a legally binding document. Therefore, there are a number of important requirements which you, as apermittee, should fully understand. These requirements are listed below. Please read and initial each requirement, in the space provided, to acknowledge that you understand your obligations. If you do not understand these obligations then please contact this Office for a full explanation. 1. Your obligation to reclaim the site is not limited to the amount of the financial warranty. You assume legal liability for all reasonable expenses which the Board or the Office may incur to reclaim the affected lands associated with your mining operation in the event your permit is revoked and financial warranty is forfeited; 2. The Board may suspend or revoke this permit, or assess a civil penalty, upon a finding that the permittee violated the terms or conditions of this permit, the Act, the Mineral Rules and Regulations, or that information contained in the application or your permit misrepresent important material facts; 3. If your mining and reclamation operations affect areas beyond the boundaries of an approved permit boundary, substantial civil penalties, to you as permittee can result; 4. Any modification to the approved mining and reclamation plan from those described in your approved application requires you to submit a permit modification and obtain approval from the Board or Office; 5. It is your responsibility to notify the Office of any changes in your address or phone number; 6. Upon permit issuance and prior to beginning on -site mining activity, you must post a sign at the entrance of the mine site, which shall be clearly visible from the access road, with the following information (Rule 3.1.12): a. the name of the operator; b. a statement that a reclamation permit for the operation has been issued by the Colorado Mined Land Reclamation Board; and, c. the permit number. 7. The boundaries of the permit boundary area must be marked by monuments or other markers that are clearly visible and adequate to delineate such boundaries prior to site disturbance; 8. It is a provision of this permit that the operations will be conducted in accordance with the terms and conditions listed in your application, as well as with the provisions of the Act and the Mineral Rules and Regulations in effect at the time the permit is issued. 9. Annually, on the anniversary date of permit issuance, you must submit an annual fee as specified by Statute, and an annual report which includes a map describing the acreage affected and the acreage reclaimed to date (if there are changes from the previous year), any monitoring required by the Reclamation Plan to be submitted annually on the anniversary date of the permit approval. Annual fees are for the previous year a permit is held. For example, a permit with the anniversary date of July 1, 1995, the annual fee is for the period of July 1, 1994 through June 30, I995. Failure to submit your annual fee and report by the permit anniversary date may result in a civil penalty, revocation of your permit, and forfeiture of your financial warranty. It is your responsibility, as the perrnittee, to continue to pay your annual fee to the Office until the Board releases you from your total reclamation responsibility. 10. For joint venture/partnership permittee: the signing representative is authorized to sign when document and a power of attorney (provided by the partner(s)) authorizing the signature of the representative is attached to this application. NOTE TO COMMENTORS/OBJECTORS: It is likely there will be additions, changes, and deletions to this document prior to final decision by the Office. Therefore, if you have any comments or concerns you must contact the applicant or the Office prior to the decision date so that you will know what changes may have been made to the application document. The Office is not allowed to consider comments, unless they are written, and received prior to the end of the public comment period. You should contact the applicant for the final date of the public comment period. If you have questions about the Mined Land Reclamation Board and Office review and decision or appeals process, you may contact the Office at (303) 866-3567. Certification: As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the following terms and conditions: I. All necessary approvals from local government have been applied for (Section 34-32.5-110(1)(a)(VIII). 2. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this application is filed, and located within 200 feet of the proposed affected area have been identified in this application (Section 34-32.5-115(4)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated by the permit boundary.) 3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)(f), C.R.S.). 4. As the applicant/operator, I do not have any mining/exploration operations in the State of Colorado currently in violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.R.S.). 5. I understand that statements in the application are being made under penalty of perjury and that false statements made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. 1984. This form has been approved by the Mined Land Reclamation Board pursuant to section 34-325-110,C.R.S., of the Colorado Land ReclamationAct for the Extraction of Construction Materials. Any alteration ormodifcationofthis form shall result invoiding any permit issued on the altered or modified form and subject the operator to cease and desist orders and civil penalties fe/4 iJliigr, without a permit pursuant to section 34-325-123, C.R.S. IQs €4.0\ 2c Signed and dated this day of r Dine b/cf{S L 4r cl t -6)(24.:;4),2 , ZI L - Applicant/Operator • r -, ::k • CoRPORATF �p•-: _�. as.... �i" t� •Z= �'. S tilt t Ll` 1 .// "nrnrmn,. Sign /to- ✓�. ./4�.'y,i. ' Corporate Secretary or Equinent_ 4 Title: %)),, f )>) cc frt 4 2 T' ✓ Town/City/County Clerk If Corporation Attest (Seal) State of L 1 ;� ., ti., --(•� ) ) ss. County of L The foregoing instrument was acknowledged before me this a ' r day of I 1 \r , . 4 \ ,by Iy:.�<1�..�1�i as )IV'�,r., I\\'k`. of Ir,,.:'1•\t./ l,r„rkAI.10 le -C b�L r(�� l R N .,c Notaryptiblic My Commission expires: I,a r ) J SIGNATURES MUST BE IN BLUE INK DEBORAH L. MORGAN — NOTARY PUBLIC COUNTY OF STATE OF LARAMIE ,' WYOMING M Cemmisaion �•res i," " EXHIBIT A: Legal Description and Location Map (1) Legal Description: a) The proposed site for the gravel pit is located at Section 34, Township 11 North, Range 58 West of the 6th P.M., Weld County, Colorado, more particularly described as: A tract being a portion of the Northeast Quarter of the Southeast Quarter (NE1/4SE1/4) and the Northwest Quarter of the Southeast Quarter (NW1/4SE1/4) of Section 34, Township 11 North, Range 58 West of the 6th P.M., Weld County, Colorado, more particularly described as follows: Beginning at a point from which the east quarter corner of said Section 34 bears N.60°18'04"E., a distance of 1395.64 feet (when considering the east line of the NE1/4 of Section 34 bears N.00°28'31"W); thence S.00°00'00"W, a distance of 434.75 feet; thence N.90°00'00"W, a distance 1000.00 feet; thence N.90°00'00"E, a distance of 434.73 ft; tehn N. 90°00'00"E a distance of 1000.00 feet to the point of beginning, containing 9.98 acres, more or less, and subject to easements, covenants and restrictions of record. Together with an easement for ingress and egress purposes, said easement being 60 feet wide and centered upon the following centerline: Beginning at a point on the north line of the above described parcel, from which the northwest corner thereof bears N.90°00'00"W, a distance of 416.74 feet; thence N.01°52'52"W, a distance of 562.42 feet; thence N.50°39'24"W.,a distance of 96.15 feet; thence S.88°11'30"W, a distance of 684.18 feet; thence N.77°37'52"W., a distance of 194.38 feet; thence N.14°15'06"E, a distance of 132.99 feet; thence N.02°26'03"E, a distance of 1385.29 feet; thence N. 26°26'41"W., a distance of 679.12 feet; thence N.39°31'55"W., a distance of 253.07 feet; thence N.69°03'54"W., a distance of 284.24 feet; thence S82°33'15"W., a distance of 427.76 feet; thence S. 81°14'42"W., a distance of 293.18 feet; thence N.71°16'03"W., a distance of 348.87 feet; thence N.80°42'32"W., a distance of 795.45 feet; thence N.39°48'22"W., for a distance of 82.13 feet to the intersection of County Road 124 and County Road 127 and said easement there terminates. g A 8 e VIM .040 —48 kill kt yCyj3� 50.0/1B •C 45YB JAM m V4Uerr- 1 �\ \\ TY JY �I N ( �\y 4J \ f,?! itl ` NO Al rr i N ca E - SEC.33 I SEC.3.7 '2USGS U.S.DEPARTIMEMOF HEIHEWOR Yip US. 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VIM SCHOOL, CO 1997 :vase✓ N M[SW+SVOR STATE OF COLORADO DIVISION OF RECLAMATION, MINING AND SA I V D Department of Natural Resources l� 1313 Sherman St., Room 215 Denver, Colorado 80203 Phone: (303) 866-3567 FAX: (303) 832-8106 April 5, 2013 MAY 0 2 2013 WELD COUNTY COMMISSIONERS Doug Keller Pine Bluffs Gravel & Excavating, Inc. 215 Main Street P.O. Box 609 Pine Bluffs, Wyoming 82042 COLORADO DIVISION OF RECLAMATION MINING SAFETY John W. Hickenlooper Governor Mike King Executive Director Loretta Pineda Director Re: Pine Bluffs Gravel & Excavating, Inc., Harms Pit, File No. M-2013-018, Receipt of 110 Construction Materials Reclamation Permit Application Package — Second Incomplete Dear Mr. Keller: On April 1, 2013, the Division of Reclamation, Mining and Safety (Division) received the 110 Construction Materials Reclamation Permit incompleteness response for the Harms Pit, File No. M-2013-018. Review of the information received determined the following items must be received before the Division can consider the application as being submitted and technical review can begin: Exhibit A - Legal Description and Location Map (Rule 6.3.1): 1. The USGS Topographic location map submitted by the Applicant indicates the main entrance location longitude as W 103° 51' 38.29" in the margin portion of the map. Please revise the location information in the margin to indicated the correct entrance location longitude of W 103° 51' 38.49". 2. The USGS Topographic location map submitted by the Applicant indicates the main entrance location at the intersection of the access road and the mine site (in red). The main entrance coordinates provided by the Applicant indicate the main entrance as the intersection of Weld County Roads 124 and 127, not the intersection of the access road and the mine site. Please review the main entrance location and revise the USGS location map or permit application accordingly. 3. The metes and bounds survey map submitted by the Applicant indicates the proposed mine site is located in Section 33. The Division believes the Applicant intended to locate the mine site in Section 34, which is consistent with the location information provided in the permit application. Please review the survey map and revise accordingly. Additionally, the Division requests the Applicant submits a complete survey map showing all metes and bounds information. Mined Land Reclamation Office of Office of Denver • Grand Junction • Durango Active and Inactive Mines Page 2 of 2 Pine Bluffs Gravel & Excavating, Inc. 4/5/13 Exhibit I - Proof of Filing with County Clerk (Rule 6.3.9): 4. Please provide an affidavit or receipt indicating the date on which the revised application in response to this letter was placed with the Weld County Clerk and Recorder. Your application will not be considered filed until the information listed above is received and found sufficient to begin our review. A decision date will be established 30 days from the date of receipt of all of the requested information. Additionally, if you have already published notice you will need to republish notice, after the Division considers the application submitted. Republication must occur once within ten (10) days of the submittal date. We will notify you when you should initiate republication of your notice. The final date for receiving comments is ten (10) days after the date of publication or the next regular business day. You have sixty (60) days from the above date to submit all necessary documents that the Office needs for an application to be considered filed. If, at the end of the sixty day period, the application has not been determined to be filed with the Office, the Office shall deny the application and terminate the application file. The response due date is May 25, 2013. This letter shall not be construed to mean that there are no other technical deficiencies in your application. The Division will review your application to determine whether it is adequate to meet the requirements of the Act after submittal of all required items. If you have any questions, please contact me at (303) 866-3567 ext. 8124. Sincere Peter S. H Environmental Protection Specialist Cc: Tom Kaldenbach; Division of Reclamation, Mining & Safety STATE OF COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY Department of Natural Resources 1313 Sherman St., Room 215 Denver, Colorado 80203 Phone: (303) 866-3567 FAX: (303) 832-8106 March 26, 2013 Doug Keller Pine Bluffs Gravel & Excavating, Inc. 215 Main Street P.O. Box 609 Pine Bluffs, Wyoming 82042 RECER/ED APR t 2 20y WELD COUNTY COMMISSIONERS COLORADO DIVISION OF RECLAMATION MINING SAFETY John W. Hickentooper Governor Mike King Executive Director Loretta Pineda Director Re: Pine Bluffs Gravel & Excavating, Inc., Harms Pit, File No. M-2013-018, Receipt of 110 Construction Materials Reclamation Permit Application Package - Incomplete Dear Mr. Keller: On March 15, 2013, the Division of Reclamation, Mining and Safety (Division) received the 110 Construction Materials Reclamation Permit Application package for the Harms Pit, File No. M- 2013-018. Preliminary review of the information received determined the following items must be received before the Division can consider the application as being submitted and technical review can begin: Application Form: 1. The Division requires Applicants to be registered with the Colorado Secretary of State's (SOS) �I office and that the application lists the exact name as registered with the SOS. Please register ,[) /your company with the SOS, provided proof of registration and revise the Applicant's name zbO-' on all applicable sections of the application form. Tau /4. On Page 3, Item #11, please report the second section of Latitude/Longitude information for the Primary Mine Entrance Location to two decimal places. 2. The Division requires the Applicant to provide documentation giving the signer the authority to sign on behalf of the company. The authorization document may be in the form of by- laws, resolution, affidavit signed by corporate secretary, certified secretary statement or a notarized statement on company letterhead. The Division did not receive a copy of Addendum 1 —Affidavit of Posting Notice at Location of Mine Site with the application package as required by Rule 1.6.2(1)(b). A sample of this notice is attached to the application form available on the Division's website. 5. On Page 3, Item #11, the two versions of the Longitude/Latitude provided by the Applicant do not correspond to each other. Please review the data and make any required revisions. V Office of Mined Land Reclamation 1)(A)[4(43 Office of Denver • Grand Junction • Durango Active and Inactive Mines A« O4 ' Page 2 of 3 Pine Bluffs Greve! & Excavating, Inc. 3/26/13 Exhibit A - Legal Description and Location Map (Rule 6.3.1(11): The legal description must identify the affected land, specify affected areas and be adequate to field locate the property. Description shall be by township, range, and section, to at least the nearest quarter -quarter section. A metes and bounds survey description is also acceptable. Also, the street address or lot number(s) may be used. This information is available from the County Assessor's office or U.S. Geological Survey (USGS) maps. 6. The Applicant provided a legal description by township, range and section, but only to the nearest quarter section. Please provide a legal description to the nearest quarter -quarter section for the proposed Harms Pit. The description must match the information provided for Item #10 on the application form. EXHIBIT A - Legal Description and Location Map (Rule 6.3.1(2)): The main entrance to the mine site shall be located based on a USGS Topographic map showing latitude and longitude or Universal Transverse Mercator (UTM). The Operator will need to specify coordinates of latitude and longitude in degrees, minutes and seconds or in decimal degrees to an accuracy of at least five (5) decimal places (e.g., latitude 37.12345 N, longitude 104.45678 W). 7. The Applicant provided a metes and bounds survey instead of specifying the main entrance Sti location in latitude and longitude or Universal Transverse Mercator. Please provide the main 4y entrance location in latitude and longitude or Universal Transverse Mercator and revise Exhibit A accordingly. See Questions #4 and #5 above. Exhibit C- Mining Plan (Rule 6.3.3): The purpose of the mining plan is to describe how mining will affect the permit area for the duration of the operation. This plan must be correlated to Exhibit E - Map. The description of the mining plan must be adequate to satisfy the requirements of Section 3.1 and demonstrate compliance with Rule 3. 8. The Applicant states the existing roads that will be used during the mining process are already established, Weld County Roads 124 and 127, and there will be no new construction of roads. Please clarify if the access roads from the mine site to the intersection of Weld County Roads 124 and 127 already exist and if they will require improvements to accommodate the mine related traffic. New or improved roads must be included as part of the permitted acreage. Therefore, if the access roads require improvements the Applicant would be required to withdraw the 110c Application for the Harms Pit and submit a 112c application package. Page 3 of 3 Pine Bluffs Gravel & Excavating, Inc. 3/26/13 0.0 Exhibit I - Proof of Piling with County Clerk (Rule 6.3.9): 9. Please provide an affidavit or receipt indicating the date on which the revised application in response to this letter was placed with the Weld County Clerk and Recorder. Your application will not be considered filed until the information listed above is received and found sufficient to begin our review. A decision date will be established 30 days from the date of receipt of all of the requested information. Additionally, if you have already published notice you will need to republish notice, after the Division considers the application submitted. Republication must occur once within ten (10) days of the submittal date. We will notify you when you should initiate republication of your notice. The final date for receiving comments is ten (10) days after the date of publication or the next regular business day. You have sixty (60) days from the above date to submit all necessary documents that the Office needs for an application to be considered filed. if, at the end of the sixty day period, the application has not been determined to be filed with the Office, the Office shall deny the application and terminate the application file. The response due date is May 25, 2013. This letter shall not be construed to mean that there are no other technical deficiencies in your application. The Division will review your application to determine whether it is adequate to meet the requirements of the Act after submittal of all required items. If you have any questions, please contact me at (303) 866-3567 ext. 8124. Sincerely, Peter S. Hays Environmental Protection Specialist Cc: Tom Kaldenbach; Division of Reclamation, Mining & Safety STATE OF COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY Department of Natural Resources 1313 Sherman St., Room 215 Denver, Colorado 80203 Phone: (303) 866-3567 FAX: (303) 832-8106 CHECK ONE: COLORADO DIVISION OF RECLAMATION MINING SAF ETY CONSTRUCTION MATERIALS LIMITED IMPACT (110) OPERATION RECLAMATION PERMIT APPLICATION FORM illThere is a File Number Already Assigned to this Operation Permit # 1013 018 __ (Please reference the file number currently assigned to this operation) New Application (Rule 1.4.5) 11 Amendment Application (Rule 1.10) Conversion Application (Rule 1.11) Permit # M - 2013 018 (provide for Amendments and Conversions 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 signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies of Exhibits A -J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the application fee described under (4) below. Exhibits should NOT 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 processing, please provide the information in the format and order described in this form. GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, ALL information described below. 1. Applicant/operator or company name (name to be used on permit): Pine Bluffs Gravel & Excavating, Inc 1.1 Type of organization (corporation, partnership, etc.): 2. Operation name (pit, mine or site namet: 3. Permitted acreage (new or existing site): 3.1 Change in acreage (+) 3.2 Total Acreage in Permit Area 4. Fees: 4.1 New Application: Amendment Fee (C.R.S. 34-32.5-125(I1)): Corporation Harms Pit 5. Primary commoditie(s) to be mined: sand gravel rock dirt 9.98 permitted acres acres acres $1258.00 application fee $827.00 application fee 5.1 Incidental commoditie(s) to be mined: 1. / Ibs/Tons/vr 2. / lbs/Tons/yr 3. / lbs/Tons/yr 4. / lbs/Tons/yr 5. / lbs/Tons/vr 5.2 Anticipated end use of primary commoditie(s) to be mined: aggregate materials for road projects for US Government Anticipated end use of incidental commoditie(s) to be mined: -2- 11. Correspondence Information: APPLICANT/OPERATOR (name, address, and phone of name to be used on permit) Contact's Name: Company Name: Street/P.O. Box: City: State: Telephone Number: Fax Number: Tyler E. Kimzey Title: President Pine Bluffs Gravel & Excavating, Inc. 215 Main Street P.O. Box: PO Box 609 Pine Bluffs WY Zip Code: 82082 (307 ) _ 245-3426 (307 ) _ 245-3748 PERMITTING CONTACT (if different from applicant/operator above) Contact's Name: Company Name: Street/P.O. Box: City: State: Telephone Number: Fax Number: INSPECTION CONTACT Contact's Name: Company Name: Street/P.O. Box: City: State: Telephone Number: Fax Number: Doug Keller Pine Bluffs Gravel & Excavating, Inc. Title: Project Manager 215 Main Street P.O. Box: PO Box 609 Pine Bluffs WY (307 ) _ 245-3426 (307 ) _ 245-3748 Zip Code: 82082 Doug Keller Title: Project Manager Pine Bluffs Gravel & Excavating, Inc. 215 Main Street P.O. Box: PO Box 609 Pine Bluffs WY Zip Code: 82082 (307 ) _ 245-3426 (307 ) _ 245-3748 CC: STATE OR FEDERAL LANDOWNER (if any) Agency: Street: City: State: Zip Code: Telephone Number: ( ) - CC: STATE OR FEDERAL LANDOWNER (if anv) Agency: Street: City: State: Zip Code: Telephone Number: ( ) -3- 7. Name of owner of the subsurface rights of affected land: 8. Name of owner of the surface of affected land: 9. Type of mining operation: ✓ Surface I l Underground In -situ Janyce Harms Janyce Harms 10. Location information: The center of the area where the majority of mining will occur: COUNTY: Weld PRINCIPAL MERIDIAN (check one): El 6th (Colorado) O 10th (New Mexico) El Ute SECTION (write number): S 34 TOWNSHIP (write number and check direction): T 11.0 North O South RANGE (write number and check direction): R 58.0 O East ri West ''` QUARTER SECTION (check one): r -I NE Ii NW ! SE I 1 SW QUARTER/QUARTER SECTION (check one): o NE f NW El SE O SW GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the approximate elevation): 20 miles east of Grover, CO; 22 miles north of New Raymer; approx. 5260 ft. elevation 11. Primary Mine Entrance Location (report in either Latitude/Longitude OR UTM): Latitude/Longitude: Example: (N) 39° 44' 12.98" (W) 104° 59' 3.87" Latitude (N): deg 40 min 53 sec 20 70' (2 decimal places) Longitude (W): deg 103 min 51 sec 38 49. (2 decimal places) OR Example: (N) 39.73691° (W) -104.98449° Latitude (N) 40 .88908 Longitude(W) 103 86069 OR Universal Tranverse Mercator (UTM) Example: 201336.3 E NAD27 Zone 13 4398351.2 N (5 decimal places) (5 decimal places) UTM Datum (specify NAD27, NAD83 or WGS 84) _ NAD83 Zone 13 Easting Northing -4- 12. Prim future (Post-minine) land use (cheepone ✓ Cropland(CR) Rangeland(RL) Residential(RS) MININNIR ..,., .-.� -- ® Developed Water Resources(WR) Pastureland(PL) Forestry(FR) Recreation(RC) ti13. Prim resent land use (check one): Cropland(CR) Ii Pastureland(PL) n Fi Rangeland(RL) El Forestry(FR) Residential(RS) fl Recreation(RC) Developed Water Resources (WR) HGeneral Agriculture(GA) Wildlife Habitat(WL) HIndustrial/Commercial(IC) Solid Waste Disposal(WD) ElGeneral Agriculture(GA) 1I Wildlife Habitat(WL) Industrial/Commercial(IC) Mining (MN) 14. If this operation will use designated chemicals, or will result, or presently has acid mine drainage - you cannot use this application form. You must submit either a 110d or 112d application form for Designated Mining Operations. In either case, you must list any acidic or toxic -forming materials, exposed or disturbed as a result of the mining operation, and whether the operation will result in or presently has acid mine drainage: None 15. Description of Amendment or Conversion: If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s): Maps & Exhibits: Submit two (2) complete, unbound copies of the following application exhibits: 6.3.1 6.3.2 6.3.3 6.3.4 6.3.5 6.3.6 6.3.7 6.3.8 6.3.9 6.3.10 6.3.12 1.6.2(1)(b) 6.5 EXHIBIT A - Legal Description and Location Map EXHIBIT B - Site Description EXHIBIT C - Mining Plan EXHIBIT D - Reclamation Plan EXHIBIT E - Maps, to include the location of any recorded easements EXHIBIT F - List of Other Permits and Licenses Required EXHIBIT G - Source of Legal Right -to -Enter EXHIBIT H - Municipalities Within a Two-mile Radius EXHIBIT I - Proof of Filing with County Clerk EXHIBIT J - Proof of Mailing Notices of Permit Application EXHIBIT L - Permanent Man -Made Structures ADDENDUM 1 - Notice Requirements (sample enclosed) Geotechnical Stability Exhibit (as required) -5 - Responsibilities as a Permittee: Upon application approval and permit issuance, this application becomes a legally binding document. Therefore, there are a number of important requirements which you, as a permittee, should fully understand. These requirements are listed below. Please read and initial each requirement, in the space provided, to acknowledge that you understand your obligations. If you do not understand these obligations then please contact this Office for a full explanation. 1. Your obligation to reclaim the site is not limited to the amount of the financial warranty. You assume legal liability for all reasonable expenses which the Board or the Office may incur to reclaim the affected lands associated with your mining operation in the event your permit is revoked and financial warranty is forfeited; 2. The Board may suspend or revoke this permit, or assess a civil penalty, upon a finding that the permittee violated the terms or conditions of this permit, the Act, the Mineral Rules and Regulations, or that information contained in the application or your permit misrepresent important material facts; 3. If your mining and reclamation operations affect areas beyond the boundaries of an approved permit boundary, substantial civil penalties, to you as permittee can result; 4. Any modification to the approved mining and reclamation plan from those described in your approved application requires you to submit a permit modification and obtain approval from the Board or Office; 5. It is your responsibility to notify the Office of any changes in your address or phone number; 6. Upon permit issuance and prior to beginning on -site mining activity, you must post a sign at the entrance of the mine site, which shall be clearly visible from the access road, with the following information (Rule 3.1.12): a. the name of the operator; b. a statement that a reclamation permit for the operation has been issued by the Colorado Mined Land Reclamation Board; and, c. the permit number. 7. The boundaries of the permit boundary area must be marked by monuments or other markers that are clearly visible and adequate to delineate such boundaries prior to site disturbance; 8. It is a provision of this permit that the operations will be conducted in accordance with the terms and conditions listed in your application, as well as with the provisions of the Act and the Mineral Rules and Regulations in effect at the time the permit is issued. 9. Annually, on the anniversary date of permit issuance, you must submit an annual fee as specified by Statute, and an annual report which includes a map describing the acreage affected and the acreage reclaimed to date (if there are changes from the previous year), any monitoring required by the Reclamation Plan to be submitted annually on the anniversary date of the permit approval. Annual fees are for the previous year a permit is held. For example, a permit with the anniversary date of July 1, 1995, the annual fee is for the period of July 1, 1994 through June 30, 1995. Failure to submit your annual fee and report by the permit anniversary date may result in a civil penalty, revocation of your permit, and forfeiture of your financial warranty. It is your responsibility, as the permittee, to continue to pay your annual fee to the Office until the Board releases you from your total reclamation responsibility. 10. For ioint venture/partnership permittee: the signing representative is authorized to sign when document and a power of attorney (provided by the partner(s)) authorizing the signature of the representative is attached to this application. -6 - NOTE TO COMMENTORS/OBJECTORS: It is likely there will be additions, changes, and deletions to this document prior to final decision by the Office. Therefore, if you have any comments or concerns you must contact the applicant or the Office prior to the decision date so that you will know what changes may have been made to the application document. The Office is not allowed to consider comments, unless they are written, and received prior to the end of the public comment period. You should contact the applicant for the final date of the public comment period. If you have questions about the Mined Land Reclamation Board and Office review and decision or appeals process, you may contact the Office at (303) 866-3567. -7 - Certification: As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the following terms and conditions: 1. All necessary approvals from local government have been applied for (Section 34-32.5-110(1)(a)(VIII). 2. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this application is filed, and located within 200 feet of the proposed affected area have been identified in this application (Section 34-32.5-115(4)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated by the permit boundary.) 3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)(f), C.R.S.). 4. As the applicant/operator, I do not have any mining/exploration operations in the State of Colorado currently in violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.R.S.). 5. 1 understand that statements in the application are being made under penalty of perjury and that false statements made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. 1984. This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32.5-110, C.R.S., of the Colorado Land Reclamation Act for the Extraction of Construction Materials. Any alteration or modification of this form shall result in voiding any permit issued on the altered or modified form and subject the operator to cease and desist orders and civil penalties fR,nki•�lll�,, without a permit pursuant to se?'on 34-32.5-123, C.R.S.• ��•�pJ". , .. , F c,,, Signed and dated this 2 g r day of .-)N-1\-0 1)/h1i 3/ 1S C trout" k -6xNk,-1_74I,1 j 16iC Applicant/Operator Title: -1)`);k-,.e )'1-1 get/ L�. 26, /3 �z�• �,ORPORATE . •-;- .7. 03 If • � If Corporation Attest (Seal) .:::,‘1.1,'• • ,:::::7 ;,gyp••• r .••'4�,, i ,' �,yy�'OM1�C Signr_ .r n� :.,�� ._ t :4* :' Corporate Secretary o1 Equi ent) 1 Town/City/County Clerk State of )ss. County of The foregoing instrument was acknowledged before me this day of CN-Ne., J C__\11 r L I -'; by �� : _r� �L.C_LtS�✓' as 1-2)C i 1P1 1\ ntti l\(V';,v.\C�(2;,c/ of )Di r o\�1v s� �� k`a) `r� k,� ., \ (h_Y Jotar Public '.) My Commission expires: SIGNATURES MUST BE IN BLUE INK I - ,1 1 ` cs) DEBORAH L. MORGAN — NOTARY PUBLIC COUNTY OF � :sr STATE OF :*r LARAMIE z. aco. WYOMING i1 M Commission res Document must be filed electronically. Paper documents are not accepted. Fees & forms are subject to change. For more information or to print copies of filed documents, visit www.sos.state.co.us. �! _ -Filed Colorado Secretary of State Date and Time: 03/27/2013 11:08 AM ID Number: 20131198158 Document number: 20131198158 Amount Paid: $100.00 ABOVE SPACE FOR OFFICE USE ONLY Statement of Foreign Entity Authority filed pursuant to § 7-90-803 of the Colorado Revised Statutes (C.R.S.) 1. The entity ID number, the entity name, and the true name, if different, are Entity ID number 20131198158 (Colorado Secretary of State ID number) Entity name Pine Bluffs Gravel & Excavating, Inc. True name (if different from the entity name) 2. The form of entity and the jurisdiction under the law of which the entity is formed are Form of entity Jurisdiction Foreign Corporation Wyoming 3. The principal office address of the entity's principal office is Street address 215 Main St (Street number and name) Suite A Pine Bluffs (City) WY 82082 (State) (ZIP/Postal Code) United States (Province — if applicable) (Country) Mailing address PO Box 609 (leave blank if same as street address) (Street number and name or Post Office Box information) Pine Bluffs WY 82082 (City) (State) (ZIP/Postal Code) United States. (Province— if applicable) (Country) 4. The registered agent name and registered agent address of the entity's registered agent are Name (if an individual) or (if an entity) TRK Enterprises, LLC (Last) (Caution: Do not provide both an individual and an entity name.) AUTHORITY (First) (Middle) (Suffix) Page 1 013 Rev. 12/01/2011 Street address 324 3rd St (Street number and name) Ault Co 80610 (City) (State) (ZIP Code) Mailing address (leave blank if same as street address) (Street number and name or Post Office Box information) (City) Co (State) (ZIP Code) (The following statement is adopted by marking the box.) p The person appointed as registered agent above has consented to being so appointed. 5. The date the entity commenced or expects to commence transacting business or conducting activities in Colorado is 05/01/2013 (mm/dd/yyyy) 6. (If applicable, adopt the following statement by marking the box and include an attachment.) O This document contains additional information as provided by law. 7. (Caution: Leave blank if the document does not have a delayed effective date. Stating a delayed effective date has significant legal consequences. Read instructions before entering a date.) (!f the following statement applies, adopt the statement by entering a date and, if applicable, time using the required format.) The delayed effective date and, if applicable, time of this document is/are (mm/dd/yyyy hour:minute am/pm) Notice: Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or acknowledgment of each individual causing such delivery, under penalties of perjury, that the document is the individual's act and deed, or that the individual in good faith believes the document is the act and deed of the person on whose behalf the individual is causing the document to be delivered for filing, taken in conformity with the requirements of part 3 of article 90 of title 7, C.R.S., the constituent documents, and the organic statutes, and that the individual in good faith believes the facts stated in the document are true and the document complies with the requirements of that Part, the constituent documents, and the organic statutes. This perjury notice applies to each individual who causes this document to be delivered to the Secretary of State, whether or not such individual is named in the document as one who has caused it to be delivered. S. The true name and mailing address of the individual causing the document to be delivered for filing are Lonny Graves (Last) PO Box 609 (First) (Middle) (Suffix) (Street number and name or Post Office Box information) Pine Bluffs WY 82082 (City) (State) (ZIP/Postal Code) United States. (Province - if applicable) (Country) (If the following statement applies, adopt the statement by marking the box and include an attachment.) O This document contains the true name and mailing address of one or more additional individuals causing the document to be delivered for filing. AUTHORITY Page 2 of 3 Rev. 12/01/2011 Disclaimer: This form/cover sheet, and any related instructions, are not intended to provide legal, business or tax advice, and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy minimum legal requirements as of its revision date, compliance with applicable law, as the same may be amended from time to time, remains the responsibility of the user of this form/cover sheet. Questions should be addressed to the user's legal, business or tax advisor(s). AUTHORITY Page 3 of3 Rev. 12/01/2011 Page 1 of 1 A Message from the Colorado Secretary of State This email is notification that the following document has been filed for Pine Bluffs Gravel & Excavating, Inc. : Statement of Foreign Entity Authority For more information, please review the record by visiting our website, www.sos.state.co.us. Select "Business Organizations" on the left and then click on "Search". You can search for the record by entering either the record name or ID number. If the ID number is used to search, the website will immediately display the Summary page for the record. If the name is used to search, the website will display a list of search results. Find the correct record and select the ID number to proceed to the Summary page. From the Summary page, you can choose to view additional information. Thank you for using the Colorado Secretary of State's online services! If you would like to share any feedback, please take our survey. This is an automatically generated email. If you would like to contact our office, please send an email to business@sos.state.co.us or call 303-894-2200 and press 2. If you would like to unsubscribe from this email notification service, visit our website, www.sos.state.co.us, select "Business Organizations" in the menu on the left, then click on "Email Notifications". file://C:\Users\Lonny\AppData\Local\Microsoft\Windows\Temporary Internet Files\Conte... 3/27/2013 CERTIFICATION I, TRISHA KIMZEY, Secretary of Pine Bluffs Gravel & Excavating, Inc., hereby certify that the following resolution was duly adopted by the Board of Directors of Pine Bluffs Gravel & Excavating, Inc., effective April 4, 2012. RESOLVED, that Doug Keller, Project Manager, of Pine Bluffs Gravel & Excavating, Inc. be, and hereby are, authorized and directed to enter into, sign, execute, deliver and perform on behalf of Pine Bluffs Gravel & Excavating, Inc., such agreements and other documents, as may be necessary or desirable in connection with bonds or other financial assurances, or application therefor, by Pine Bluffs Gravel & Excavating, Inc. pursuant to or in connection with the Weld County Harms Pit Application and the rules and regulations pursuant thereto. I further certify that said resolution has not been amended or repealed and is still in full force and effect. IN WITNESS WHEREOF, I hereunto set my hand and affixed the seal of Pine Bluffs Gravel & Excavating, Inc. this 28th day of March, 2013. C - / „p, Trisha Kimzey Pine Bluffs Gravel & Excavating, Inc. Corporate Secretary State of Wyoming ss. County of Laramie The foregoing instrument was acknowledged before me by TRISHA KIMZEY, Secretary of Pine Bluffs Gravel & Excavating, Inc., this ,),> day of 1 Y�C. ! V"\ , 2013. a..st •. M90RGAP3 — Pd0TARY PU64.IC -,, �.:. t,j.., :,c ;?� STATE OF ,;; . G ;:: qtiiSe WY0WY0MINGyQfllinlvuS10f1 ry lies Public or authorized officer( Title My commission expires: NOTICE This site is the location of a proposed mining operation. Pine Bluffs Gravel & Excavating, Inc., whose address and phone number is 215 Main Street, PO Box 609, Pine Bluffs, WY 82082, Phone Number (307) 245-3426, has applied for a Reclamation Permit with the Colorado Mined Land Reclamation Board. Anyone wishing to comment on the application may view the application at the Weld County Clerk and Recorder's Office, 1402 N. 17`h Avenue, Greeley, CO 80631, and should send comments prior to the end of the public comment period to the Division of Reclamation, Mining and Safety, 1313 Sherman St., Room 215, Denver, CO 80203. Certification: I, Doug Keller, hereby certify that I osted a sign corAining the above notice for the proposed permit area known as the Harms Pit, on /73c.c rch 3 , 2013. Signaturc! Date EXHIBIT A: Legal Description and Location Map (1) Legal Description: a) The proposed site for the gravel pit is located at Section 34, Township 11 North, Range 58 West of the 6th P.M., Weld County, Colorado, more particularly described as: A tract being a portion of the Northeast Quarter of the Southeast Quarter (NE1/4SE1/4) and the Northwest Quarter of the Southeast Quarter (NW1/4SE1/4) of Section 34, Township 11 North, Range 58 West of the 6th P.M., Weld County, Colorado, more particularly described as follows: Beginning at a point from which the east quarter corner of said Section 34 bears N.60°18'04"E., a distance of 1395.64 feet (when considering the east line of the NE1/4 of Section 34 bears N.00°28'31"W); thence S.00°00'00"W, a distance of 434.75 feet; thence N.90°00'00"W, a distance 1000.00 feet; thence N.90°00'00"E, a distance of 434.73 ft; tehn N. 90°00'00"E a distance of 1000.00 feet to the point of beginning, containing 9.98 acres, more or less, and subject to easements, covenants and restrictions of record. Together with an easement for ingress and egress purposes, said easement being 60 feet wide and centered upon the following centerline: Beginning at a point on the north line of the above described parcel, from which the northwest corner thereof bears N.90°00'00"W, a distance of 416.74 feet; thence N.01°52'52"W, a distance of 562.42 feet; thence N.50°39'24"W.,a distance of 96.15 feet; thence 5.88°11'30"W, a distance of 684.18 feet; thence N.77°37'52"W., a distance of 194.38 feet; thence N.14°15'06"E, a distance of 132.99 feet; thence N.02°26'03"E, a distance of 1385.29 feet; thence N. 26°26'41"W., a distance of 679.12 feet; thence N.39°31'55"W., a distance of 253.07 feet; thence N.69°03'54"W., a distance of 284.24 feet; thence S82°33'15"W., a distance of 427.76 feet; thence S. 81°14'42"W., a distance of 293.18 feet; thence N.71°16'03"W., a distance of 348.87 feet; thence N.80°42'32"W., a distance of 795.45 feet thence N.39°48'22"W., for a distance of 82.13 feet to the intersection of County Road 124 and County Road 127 and said easement there terminates. O 77 Q to 10 cri 0 S w 1.3 N 02, • \ lN,zc.IN cal k i .ft 1 i i I EXHIBIT C: MINING PLAN (RULE 6.3.3): The existing road used during the mining process is already established, Weld County Roads 124 and 127, and there will be no new construction of roads. The access road from the mine site to the intersection of Weld County Roads 124 and 127 already exist and will not require any improvements to accommodate the mine related traffic. There will be no new roads or improvements on any of the roads involved. AFFIDAVIT OF MAILING In the Matter of the Limited Impact (110) Operation Reclamation Permit Application State of Wyoming ) County of Laramie ) ss. Doug Keller, of Pine Bluffs Gravel & Excavating, Inc., being duly sworn, deposes and says: That he is over the age of eighteen years; That on MarCh c b' , 2013, by regular first class and/or certified mail properly enclosed in a sealed envelope with the prepaid postage thereon, he deposited in the United States mail, at 115 W. 4th Street, Pine Bluffs, WY, 82042, notices, a true and correct copy of the Revised Application of the Construction Materials Limited Impact (110) Operation Reclamation Permit Application Form, address to the following: Weld County Clerk/Recorder 1402 N 17th Avenue Greeley, CO 80631 The receipts for certification of said letters are hereunto annexed and made a part hereof. I certify that the foregoing is true and correct. Dated this G day of 727a /'Gk , 2013. Doug Keller, f foject Manager �~ Affiant 0001 0714 7695 a is Return Rec O N 2 v p z LL, h f n E T T Z y CO N N E o u. cv a • a 0. a ;69L h'CL0 ¶000 2'192 900e - 569L h'LLU ¶000 2'192 9221 111111111111 .._�� UHI1 U3u1V .oa U1D 553!'OOy N'dl11BB 3111.40 .. 1HOItl 3M1013dD13AN3 3O d' 117 b3HOi13 3at'ld ►�\n Sher na cosy, d+ . N CO ID ; - m o2a�0 ) N'6 ° a ¢ y°Eo. 6 181 E. O. . m ill. ant,gEtt.E. 8 BE 241$ ■ ■ .M tole Number sfer from service label) cc,, 3811, Total Pc TOLL fi1LU 1000 01Q2 g00L TOLL h1L0 1000 OTV2 Q00L i u i i '71V141. 113111.1183 ... - 324405 itoa..'� Uuu ssarla SOKI0 ��+a �o N�IF! 3Hit{Y d'dG 3 N3 Qty .1J₹' •F Xace.STOrld STATE OF COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY Dsparonent of Natural Resources 1313 Sherman St., Room 215 Denver, Colorado 80203 Phone. (3031866-3567 FAX: (303) 832-8106 CONSTRUCTION MATERIAL LIMITED IMPACT (110) OPERATION RECLAMATION PERMIT APPLICATION PACKAGE APPLICABILITY: COLORADO DIVISION OF RECLAMATION MINING - &- SAFETY RECEIVED MAR 1 1 2C`3 WELD COUNTY COMMISSIONERS This application package is for a construction material extraction operation affecting LESS than 10 acres. If you plan to conduct a construction material extraction operation which meets these criteria, please follow the instructions provided in this package, in the Rules and Regulations, and in the Colorado Land Reclamation Act for the Extraction of Construction Materials, as required. RECOMMENDATIONS PRIOR TO FILING: The Construction Material Rules and Regulations (the Colorado Land Reclamation Act for the Extraction of Construction Materials, Section 34-32.5-101, et seq., C.R.S., and 2 CCR 407-1), and the Colorado Mined Land Reclamation Board (the "Board") regulate the permitting, operational and reclamation requirements for all construction material extraction operations in Colorado. It is your obligation to comply with the Act and Regulations. You are encouraged to obtain and review a copy of the Rules, available for SS.00 from the Division of Reclamation, Mining, and Safety (the "Office"). In order to submit your application properly, it is recommended that you review the Act and: Rule 1.1 Definitions; Rule 1.4 Application Review and Consideration Process; Rule 1.6 Public Notice Procedures; Rule 3.1 Reclamation Performance Standards; Rule 3.3.1 Operating without a Permit - Penalty; Rule 4 Performance Warranties and Financial Warranties; Rule 6 Permit Application Exhibit Requirements; Rule 6.2 General Requirements of Exhibits; Rule 6.3 Specific Permit Application Exhibit Requirements; Rule 6.5 Geotechnical Stability Exhibit (as required). It is recommended that you contact the agencies listed in the application section titled "Compliance With Other Laws" prior to submitting the application to the Office . Office of Mined Land Reclamation Office of Denver • Grand Junction • Durango Active and Inactive Mines 2013-0693 FILING REOUIREMENTS: In order to apply for a Reclamation Permit for a Limited Impact Operation, please provide: o One (I ) signed and notarized completed ORIGINAL and one (1) copy of the completed original Limited Impact Operation (110) Application Form. ORIGINAL SIGNATURES MUST BE IN BLUE INK. o Two (2) copies of Exhibits A -J and Exhibit L (required sections described in Rule 6). o Two (2) copies of Addendum 1 - Notice requirements (described in Rule 1.6.2(1)(6)). A sample of this notice is attached for your use. o The Geotechnical Stability Exhibit when required by the Division. o The application fee. The thirty (30) day period for review of the application and exhibits will NOT begin until all required information and fee are submitted. The Office will then review the submitted information for adequacy. NOTICE REOUIREMENTS: I . You MUST send a notice, on a form approved by the Board, to the local board of county commissioners. A copy of this "Notice of Filing Application" form is attached for your use. 2. If the mining operation is within the boundaries of a conservation district, send a notice to the board of supervisors of the conservation district PRIOR to filing the application. A copy of this "Notice of Filing Application" form is attached for your use. 3. You MUST include proof of notice #1 and #2 above with the application at the time the application is submitted to the Office for filing (Rule 1.6.2(1)(g)). 4. PRIOR to filing the application, place for public review a copy of the application, less confidential items, with the clerk or recorder of the county or counties in which the affected land is located. 5. You MUST include an affidavit or receipt demonstrating that the application was filed with the county clerk or recorder at the time the application is submitted to the Office for filing. 6. Any changes or additions made to an application submittal MUST be filed with the county clerk or recorder. You MUST also provide the Office with an affidavit or receipt demonstrating that the change was filed with the county clerk or recorder no later than the close of business on the day the change was filed with the Office (Rule 1.8.1(2)). 7. Within ten (10) days after your application is considered filed, you must publish once in a newspaper of general circulation, in the locality of the proposed mining operation, the notice described in Rule 1.6.2(1)(d). A copy of a form which includes all required information for the notice has been attached for your use. 8. In addition, after the publication you must mail or personally serve a copy of the notice described in Rule 1.6.2(1)(d) to all owners of record of surface rights to the affected land and all owners of lands that are within 200 feet of the boundary of the affected land (Rule 1.6.2(I)(e)). 9. Prior to the Office making a decision (consideration of the application), you MUST submit a copy of the proof of publication from the newspaper and proof of all required notices. Proof of the notices may be by submitting copies of return receipts of a certified mailing or by proof of personal service (Rules 1.4.1(4), 1.4.2(4)(c), 1.6.2(I)(a)(ii), and 1.6.2(1)(g)). The copy of the application and any changes or additions placed at the office of the county clerk or recorder shall NOT be recorded, but shall be retained there for at least sixty (60) days after a decision on the application by the Office and be available for inspection during this period. At the end of this period, the application may be reclaimed by the applicant or destroyed (Rule 1.6.2(2)). APPLICATION REVIEW PROCEDURES: The Office shall approve or deny the application within thirty (30) days of filing unless the date for consideration by the Office is extended pursuant to Rule 1.8. The time for consideration shall not be extended beyond thirty (30) days after the last such change submitted. For complex applications, the review period may be extended an additional sixty (60) days. Please see Rule 1.10 0) for the definition of what constitutes a complex application. APPLICATION APPROVAL/DENIAL: If the requirements of the Act and Mineral Rules have been satisfied, the Office will approve the application. The Act also provides for automatic approval if no action is taken by the Office by the end of the review period. If the Act and Regulation requirements have not been satisfied, the Office will deny the application. If the Office denies the application, you may appeal to the Board for a final determination by submitting a written request for administrative appeal to the Board within 60 days of the decision date (Rule 1.4.7). PERFORMANCE AND FINANCIAL WARRANTIES: A performance warranty, and a financial warranty dollar amount determined during the application review process, must be submitted and approved by the Office PRIOR to permit issuance. A financial warranty should NOT be submitted until a decision on the application has been made. If the applicant is a unit of state or county government, then ONLY a performance warranty is required. Several different types of financial warranties are allowed by the law. Please review Rule 4.0 to determine which type of financial warranty you desire to use. You may obtain the appropriate warranty forms from the Office during the application review period. Please note that an application approval DOES NOT convey a right to begin operations. You MUST submit, and have approval of your performance and financial warranties, and receive your copy of the signed permit document PRIOR to beginning on -site mining activity. AUTOMATIC PERMIT APPROVAL: An automatic approval will occur where the Office fails to notify the applicant/operator that the application has been denied. This decision must be made thirty (30) calendar days from the date the application was determined to have been filed. However, the performance and financial warranties must be submitted and approved by the Office before the permit will be issued even if you receive an automatic approval. NO MINING OPERATIONS SHALL BEGIN UNTIL A PERMIT IS ISSUED (Section 34-32.5-109O), C.R.S.). COMPLIANCE WITH OTHER LAWS: Compliance with the Act and Rules and Regulations of the Mined Land Reclamation Board DOES NOT relieve you of your responsibility to comply with all other applicable state and federal laws. We recommend that you contact the following agencies to determine whether you need to comply with their legal requirements: o The Colorado State Historical Preservation Office regarding properties of historical significance including the need for an archeological survey, procedures for requesting a file search, and inventory forms to identify structures. o Colorado Division of Water Resources with regard to water rights; o Colorado Department of Health, Water Quality Control Division, with regard to the discharge of pollutants into the State waters; o Colorado Department of Health, Air Pollution Control Division, with regard to the need for a fugitive dust permit; o U.S. Bureau of Land Management or the U.S. Forest Service if the proposed operation will occur on federal lands; o U. S. Army Corps of Engineers regarding a dredge and fill (404) permit; and o The County Planning Department for the county or counties in which your proposed operation is located. - iv - Section 34-32.5-109(3), C.R.S. requires a mining operator to be responsible for assuring that the mining operation and the post -mining land use comply with local land use regulations and any master plan for extraction adopted pursuant to Section 34-1-304, C.R.S. COMPLETION OF MINING: Upon completion of any phase of reclamation, you should consult Rule 3.1 for reclamation standards and 4.16 for details on how to request a reclamation responsibility release from the Board. STATE OF COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY Department of Natural Resources 1313 Sherman St., Room 215 Denver, Colorado 80203 Phone: (303) 866-3567 FAX: (303) 832-8106 CHECK ONE CONSTRUCTION MATERIALS LIMITED IMPACT (110) OPERATION RECLAMATION PERMIT APPLICATION FORM There is a File Number Already Assigned to this Operation COLORADO DIVISION OF RECLAMATION MINING —&— SAFETY Permit # M - - - (Please reference the file number currently assigned to this operation) New Application (Rule 1.4.5) 1L Amendment Application (Rule 1.10) Conversion Application (Rule 1.11) Permit # M - (provide for Amendments and Conversions of existing permits) The application for a Construction Materials Limited Impact (1 10) 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)(6); and (3) the application fee. When you submit your application, be sure to include one (I) complete signed and notarized ORIGINAL and one (1) copy of the completed application form, two (2) copies of Exhibits A -J, Exhibit L, Addendum 1, and appropriate sections of 6.5 (Geotechnical Stability Exhibit), as required, and a check for the application fee described under (4) below. Exhibits should NOT 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 processing, please provide the information in the format and order described in this form. GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, ALL information described below. I. Applicant/operator or company name (name to be used on permit): Pine Bluffs Gravel & Excavating 1.1 Type of organization (corporation, partnership, etc.): _ 2. Operation name (pit, mine or site name): Harms Pit 3. Permitted acreage (new or existing site): 3.1 Change in acreage (+) 3.2 Total Acreage in Permit Area 4. Fees: 4.1 New Application: Amendment Fee (C.R.S. 34-32.5-125(II)): Corporation 5. Primary commoditie(s) to be mined: sand gravel rock dirt 9.98 permitted acres acres acres $1258.00 application fee $827.00 application fee 5.1 Incidental commoditie(s) to be mined: I. / Ibs/Tons/vr 2. / Ibs/Tons/vr 3. / lbs/Tons/yr 4. / lbs/Tons/yr 5. / Ibs/Tons/vr 5.2 Anticipated end use of primary commoditie(s) to be mined: Anticipated end use of incidental commoditie(s) to be mined: aggregate materials for road projects for US Government -2- I I. Correspondence Information: APPLICANT/OPERATOR (name, address, and phone of name to be used on permit) Contact's Name: Company Name: Street/P.O. Box: City: State: Telephone Number: Fax Number: PERMITTING CONTACT Contact's Name: Company Name: Street/P.O. Box: City: State: Telephone Number: Fax Number: INSPECTION CONTACT Contact's Name: Company Name: Street/P.O. Box: City: State: Telephone Number: Fax Number: Tyler E Kimzey Pine Bluffs Gravel & Excavating, Inc. Title: President 215 Main Street Pine Bluffs P.O. Box: PO Box 609 WY (307 ) _ 245-3426 307 ) _ 245-3748 (if different from applicant/operator above) Doug Keller Pine Bluffs Gravel & Excavating, Inc. Zip Code: 82042 Title: Project Manager 215 Main Street Pine Bluffs P.O. Box: PO Box 609 WY (307 ) _ 245-3426 (307 ) _ 245-3748 Doug Keller Pine Bluffs Gravel & Excavating, Inc. Zip Code: 82042 Title: Project Manager 215 Main Street Pine Bluffs P.O. Box: PO Box 609 WY (307 ) _ 245-3426 (307- ) _ 245-3748 CC: STATE OR FEDERAL LANDOWNER (if any) Agency: Street: City: State: Zip Code: 82042 Zip Code: Telephone Number: ( ) - CC: STATE OR FEDERAL LANDOWNER (if any) Agency: Street: City: State: Zip Code: Telephone Number: ( ) - 7. Name of owner of the subsurface rights of affected land: 8. Name of owner of the surface of affected land: 9. Type of mining operation: Surface Janyce Harms Janyce Harms Underground In -situ 10. Location information: The center of the area where the majority of mining will occur: COUNTY: Weld PRINCIPAL MERIDIAN (check one): SECTION (write number): TOWNSHIP (write number and check direction): RANGE (write number and check direction): QUARTER SECTION (check one): QUARTER/QUARTER SECTION (check one): 6th (Colorado) S 34 T 11.0 R 58.0 n C NE NE ® I Oth (New Mexico) North � East t r ,j j'El 1 NW 0 SE n NW E] SE D SW South Ute West SW GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the approximate elevation): 20 miles east of Grover, CO; 22 miles north of New Raymer; approx. 5260 ft elevation I I. Primary Mine Entrance Location (report in either Latitude/Longitude OR UTM): Latitude/Longitude: Example: (N) 39° 44' 12.98" (W) 104° 59' 3.87" Latitude (N): deg 40 Longitude (W): deg 103 OR Example: (N) 39.73691° (W) -104.98449° Latitude (N) 40 Longitude(W) 103 min 52 sec 46 16,446.00 (2 decimal places) min 50 sec 52 .7s.sos.00 (2 decimal places) 88,908.00000 (5 decimal places) 86,069.00000 (5 decimal places) OR Universal Tranverse Mercator (UTM) Example: 201336.3 E NAD27 Zone 13 4398351.2 N UTM Datum (specify NAD27, NAD83 or WGS 84) _ NAD83 Easting Northing 13 Zone 12. Prima future (Post -minim') land use (chec ): ✓ Cropland(CR) Pastureland(PL) ,.,,„ Rangeland(RL) Forestry(FR) Residential(RS) Recreation(RC) 7 Developed Water Resources(WR) 13. Prims�rv�nresent land use (check one): t• I Cropland(CR) © Pastureland(PL) © Rangeland(RL) In Forestry(FR) Residential(RS) nRecreation(RC) Developed Water Resources (WR) iGeneral Agriculture(GA) Wildlife Habitat(WL) Industrial/Commercial(IC) Solid Waste Disposal(WD) • General Agriculture(GA) ▪ Wildlife Habitat(WL) Industrial/Commercial(IC) Mining (MN) I 1 14. If this operation will use designated chemicals, or will result, or presently has acid mine drainage - you cannot use this application form. You must submit either a 110d or 112d application form for Designated Mining Operations. In either case, you must list any acidic or toxic -forming materials, exposed or disturbed as a result of the mining operation, and whether the operation will result in or presently has acid mine drainage: None 15. Description of Amendment or Conversion: If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s): Maps & Exhibits: Submit two (2) complete, unbound copies of the following application exhibits: 6.3.1 EXHIBIT A - Legal Description and Location Map 6.3.2 EXHIBIT B - Site Description 6.3.3 EXHIBIT C - Mining Plan 6.3.4 EXHIBIT D - Reclamation Plan 6.3.5 EXHIBIT E - Maps, to include the location of any recorded easements 6.3.6 EXHIBIT F - List of Other Permits and Licenses Required 6.3.7 EXHIBIT G - Source of Legal Right -to -Enter 6.3.8 EXHIBIT H - Municipalities Within a Two-mile Radius 6.3.9 EXHIBIT I - Proof of Filing with County Clerk 6.3.10 EXHIBIT J - Proof of Mailing Notices of Permit Application 6.3.12 EXHIBIT L - Permanent Man -Made Structures 1.6.2(1)(b) ADDENDUM 1 - Notice Requirements (sample enclosed) 6.5 Geotechnical Stability Exhibit (as required) Certification: As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the following terms and conditions: I. All necessary approvals from local government have been applied for (Section 34-32.5-110(1)(a)(Vlll). 2. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this application is filed, and located within 200 feet of the proposed affected area have been identified in this application (Section 34-32.5-115(4)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated by the permit boundary.) 3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)(f), C.R.S.). 4. As the applicant/operator, I do not have any mining/exploration operations in the State of Colorado currently in violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.R.S.). 5. I understand that statements in the application are being made under penalty of perjury and that false statements made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. 1984. This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32.5-110,C.R.S., of the Colorado Land Reclamation Act for the Extraction of Construction Materials. Any alteration or modification of this form shall result in voiding any permit issued on the altered or modified form and subject the operator to cease and desist orders and civil penalties for operating without a permit pursuant to section 34-32.5-123, C.R.S. I Signed and dated this day of IL( ✓ C1 L / 5 "V EL "'' ., If Corporation Attest (Seal) T: CORPORATE ,-7 Title: t f 1„,t• c'l Iii/ 4 ) 14P1/&r- Applicant/Operator (et - State of , : t ss. County of 1 d� �n y. Le The foregoing instrument was acknowledged before me this Tj 4-, day of ,by 1 yiv.Qs. as Pfil�fCYlm.v N� •SE♦1T • •• •• 1p; 2l Signet.. A6") Arift,? (�•..... req.)", e rUMIPl�'.••% Corporate Secretary or Equivalent'""% t'"' Town/City/County Clerk DEBORAH 1. MORGAN - NOTARY PUBLIC COUNTY OF Y Iti STATE OF LARAMIE ,., 4 WYOMING My Commission Ex g', )1Y \e,. vr'v'\ . "anl'3 of �-)ir‘ 0110 '1f No . blic My Commission expires: ; A -. )1 -15 SIGNATURES MUST BE IN BLUE INK Responsibilities as a Permittee: Upon application approval and permit issuance, this application becomes a legally binding document. Therefore, there are a number of important requirements which you, as a permittee, should fully understand. These requirements are listed below. Please read and initial each requirement, in the space provided, to acknowledge that you understand your obligations. If you do not understand these obligations then please contact this Office for a full explanation. 1. Your obligation to reclaim the site is not limited to the amount of the financial warranty. You assume legal liability for all reasonable expenses which the Board or the Office may incur to reclaim the affected lands associated with your mining operation in the event your permit is revoked and financial warranty is forfeited; 2. The Board may suspend or revoke this permit, or assess a civil penalty, upon a finding that the permittee violated the terms or conditions of this permit, the Act, the Mineral Rules and Regulations, or that information contained in the application or your permit misrepresent important material facts; 3. If your mining and reclamation operations affect areas beyond the boundaries of an approved permit boundary, substantial civil penalties, to you as permittee can result; 4. Any modification to the approved mining and reclamation plan from those described in your approved application requires you to submit a permit modification and obtain approval from the Board or Office; 5. It is your responsibility to notify the Office of any changes in your address or phone number; 6. Upon permit issuance and prior to beginning on -site mining activity, you must post a sign at the entrance of the mine site, which shall be clearly visible from the access road, with the following information (Rule 3.1.12): a. the name of the operator; b. a statement that a reclamation permit for the operation has been issued by the Colorado Mined Land Reclamation Board; and, c. the permit number. 7. The boundaries of the permit boundary area must be marked by monuments or other markers that are clearly visible and adequate to delineate such boundaries prior to site disturbance; 8. It is a provision of this permit that the operations will be conducted in accordance with the terms and conditions listed in your application, as well as with the provisions of the Act and the Mineral Rules and Regulations in effect at the time the permit is issued. 9. Annually, on the anniversary date of permit issuance, you must submit an annual fee as specified by Statute, and an annual report which includes a map describing the acreage affected and the acreage reclaimed to date (if there are changes from the previous year), any monitoring required by the Reclamation Plan to be submitted annually on the anniversary date of the permit approval. Annual fees are for the previous year a permit is held. For example, a permit with the anniversary date of July I, 1995, the annual fee is for the period of July 1, 1994 through June 30, 1995. Failure to submit your annual fee and report by the permit anniversary date may result in a civil penalty, revocation of your permit, and forfeiture of your financial warranty. It is your responsibility, as the permittee, to continue to pay your annual fee to the Office until the Board releases you from your total reclamation responsibility. 10. For joint venture/partnership permittee: the signing representative is authorized to sign when document and a power of attorney (provided by the partner(s)) authorizing the signature of the representative is attached to this application. -6 - NOTE TO COMMENTORS/OBJECTORS: It is likely there will be additions, changes, and deletions to this document prior to final decision by the Office. Therefore, if you have any comments or concerns you must contact the applicant or the Office prior to the decision date so that you will know what changes may have been made to the application document. The Office is not allowed to consider comments, unless they are written, and received prior to the end of the public comment period. You should contact the applicant for the final date of the public comment period. If you have questions about the Mined Land Reclamation Board and Office review and decision or appeals process, you may contact the Office at (303) 866-3567. PINE BLUFFS GRAVEL & EXCAVATING, INC. dba Cornhusker Concrete and dba B&D Dozer PO Box 609 Phone: 307-245-3426 PINE BLUFFS WY 82082 Fax: 307-245-3748 February 26, 2013 Weld County Clerk/Recorder 1402 N. 17th Avenue Greeley, CO 80631 RE: Gravel Permit Application Dear Sir: Enclosed with this letter please find a copy of the application, less the confidential information, that we intend to file with the Colorado Division of Reclamation, Mining and Safety, as instructed in the Notice Requirements of their instructions. Per the instructions, we are to place for public review a copy of the application, less confidential information, with the clerk or recorder of the county or counties in which the affected land is located. I do not believe this will need to be recorded, just available for public review. If you require any additional information, please contact me. Thank you in advance for your assistance in this matter. Sincerely, /7/ DOUg Keller/ /`-c`.. Project Manager EXHIBIT A: Legal Description and Location Map (1) Legal Description: a) The proposed site for the gravel pit is located at Section 34, Township 11 North, Range 58 West of the 6th P.M., Weld County, Colorado, more particularly described as: A tract being a portion of the Southeast Quarter (SE1/4) of Section 34, Township 11 North, Range 58 West of the 6`h P.M., Weld County, Colorado, more particularly described as follows: Beginning at a point from which the east quarter corner of said Section 34 bears N.60°18'04"E., a distance of 1395.64 feet (when considering the east line of the NE1/4 of Section 34 bears N.00°28'31"W); thence S.00°00'00"W, a distance of 434.75 feet; thence N.90°00'00"W, a distance 1000.00 feet; thence N.90°00'00"E, a distance of 1000.00 feet to the point of beginning, containing 9.98 acres, more or less, and subject to easements, covenants and restrictions of record. Together with an easement for ingress and egress purposes, said easement being 60 feet wide and centered upon the following centerline: Beginning at a point on the north line of the above described parcel, from which the northwest corner thereof bears N.90°00'00"W, a distance of 416.74 feet; thence N.01°52'52"W, a distance of 562.42 feet; thence N.50°39'24"W.,a distance of 96.15 feet; thence 5.88°11'30"W, a distance of 684.18 feet; thence N.77°37'52"W., a distance of 194.38 feet; thence N.14°15'06"E, a distance of 132.99 feet; thence N.02°26'03"E, a distance of 1385.29 feet; thence N. 26°26'41"W., a distance of 679.12 feet; thence N.39°31'SS"W., a distance of 253.07 feet; thence N.69°03'54"W., a distance of 284.24 feet; thence 582°33'15"W., a distance of 427.76 feet; thence S. 81°14'42"W., a distance of 293.18 feet; thence N.71°16'03"W., a distance of 348.87 feet; thence N.80°42'32"W., a distance of 795.45 feet; thence N.39°48'22"W., for a distance of 82.13 feet to the intersection of County Road 124 and County Road 127 and said easement there terminates. (2) The main entrance to the mine site based on a USGS Topographic Map with specific coordinates of latitude and longitude in degrees, minutes and seconds: Beginning at a point on the north line of the above described parcel, from which the northwest corner thereof bears N.90°00'00"W, a distance of 416.74 feet; thence N.01°52'52"W, a distance of 562.42 feet; thence N.50°39'24"W.,a distance of 96.15 feet; thence S.88°11'30"W, a distance of 684.18 feet; thence N.77°37'52"W., a distance of 194.38 feet; thence N.14°15'06"E, a distance of 132.99 feet; thence N.02°26'03"E, a distance of 1385.29 feet; thence N. 26526'41"W., a distance of 679.12 feet; thence N.39°31'55"W., a distance of 253.07 feet; thence N.69°03'54"W., a distance of 284.24 feet; thence 582°33'15"W., a distance of 427.76 feet; thence S. 81°14'42"W., a distance of 293.18 feet; thence N.71°16'03"W., a distance of 348.87 feet; thence N.80°42'32"W., a distance of 795.45 feet; thence N.39°48'22"W., for a distance of 82.13 feet to the intersection of County Road 124 and County Road 127 and said easement there terminates. See attached map. (3) A map showing information to determine the location of the affected land on the ground and existing and proposed roads or access routes to be used in connection with the mining operation, including the names of the immediately adjacent surface owners of record. (see attached) Weld County Roads 124 and 127 will be used for transportation to and from gravel pit. The names of the immediately adjacent surface owners of record include: Janyce Harms, See attached map. •0 N 'r1 3 L C a qj V 8 O O 00 n O • 8 i S'of A/ krt u J x O U J yO ° 0. N ≤ N 0. U 4 g -- a 0 • IS h O y X H C. CO N b J uuyyC. p ▪ W N U' vc u ■ 000 SONOav38 30 SISV8 "Mi O Y c u r n •-• I, ° E 3 _u 0 a J O O _T ° n tl O W Y b E Y 3 b ° Y ,S ° C cb, S• . N VW�;• .V. V Z; e 5 S g S O o „ /O N o O N N< • N N V na :; . 0• CO 0 O OY. • u 01 _. _ N f m_O C o S. t%j N`O ai- O O On.„�n N ^ . 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Y. ^ T °O Y O` C i- � OY^ N ocO NCO u O O 10 < • 00 iO`0n ON`O(O OZ o P u rl CC? O C Z -' C 2 b i, 0 CrP 2 tl 2 V 2 y V1 0 2 c N_ O c y C V O w C 0 V V 0• c C u 0 u 0 u 0 V O u a a _ b ` O O Y V° D J p O y b Y V N V^ Y a Y n V d O <r a. CO O'. O O I-.6 01-5 05 0565050CC A.4' Yt.a 7, I \ 3 a Agn .n If TN O O NOY Y w it 0 . T a E V C oEn�0 u -y c t M y ^ c 0 o b E V Y tl b 4 V a S w a Ji 2 0 O• PO u S J Aa o E i O Y c �—O c O Z o 0 4 y E o ° o o a 3 C a c ^ c 13 c O 0 0.11 ° E g00 u a v p 0 ; 2‘C O Q s O C.j C 05 O Tp ti o ▪ 0 Y • E� o O� u 6 O 0 - • `YL� Y Ta T O p tl v u u E v l 0 5 O n 1.1 iu V O p ] 0 3.0, ao .ON K 8 8 200,00a 24 eft a on .zOs .N -a L -d1 b , ' /-t- t2-5 PREPARED ✓ANURARY, 2013 Q •eso O N n - b U b 4 pp N p CN2NYIZN,NU 0 a s p-nN—YI V •I on°moa' _` 9§Z�2 2 �v1 a°.§C-iO— bO b8=° W -P' SU 0 $a pNPp.,o_. i .). o 2.0S 0oln OaDnn Nips 4 NN° xt gi PJ Lyy2 iy=y=b%; at g 8 K.S:Se§55 b s 1i j 6 l be i o ≤ a O§ u uu 5 tax5 55; pE:_faF3 .S JNI =yNj;;N'egmv Y . Q Si P . na2s ., 0Dana. M+ y a N b r N r O G. aYO pl. pN p�pp 58 fSzbz z Yt.zFn q .S a • ° Y Y u oa yi bo§aao-ci 85nb' mg-45bgu5'-Sgos $�1. H�LM3Y !0 ssYa Yo 'ram - - \ W \\ a cc 1{{ 1 I tg 1st PC 9 52 t i ittlgt aa .cp NI Its '4 'DM o 4 14 (4 a t _it≤ us Z S 0 Zz SEC. 33 I SEC 34 Eyhi&I- c3) EXHIBIT B: Site Description (a) Vegetation and soil characteristics: The potential vegetation is about 70-85% grasses and grass -like plants, 10-15% forbs and 5- 15% woody plants. The dominant tall warm season grasses are prairie sandreed, sand bluestem and switchgrass. Blue grama dominates the understory. Important cool season grasses and grass likes are needleandthread and sun sedge. The grasses range from 2 inches to 30 inches in height depending on variety. Key forbs and shrubs are American vetch, pacific peavine, purpose prairie clover, western sandcherry and leadplant. The diversity in plant species allows for high drought tolerance. Plant litter is properly distributed with very little movement off -site and natural plant mortality is very low. The land is labeled as Altvan fine sandy loam and Nunn loam, both with 0 to 6 percent slope. The down -slope shape and across -slope shape for both loam types is linear. The depth to the water table is more than 80 feet. The soil for the Altvan sand is 0 to 6 inches fine sandy loam; 6 to 22 inches, sandy clay loam; 22 to 27 inches, sandy clay loam, and 27 to 60 inches, gravelly coarse sand. The soil for the Nunn loam is 0 to 7 inches: loam; 7 to 23 inches, clay loam; 23 to 60 inches clay loam; and 60 to 64 inches, sandy clay loam. The topsoil with proper fertilization, mulching, and seed bed preparation is suitable for revegetation to the native grass species recommended by the local NRCS. Below the sandy loam topsoil is located a sand to gravel deposit estimated to be 6 to 10 feet deep. Available water capacity is low. This unit is used as dryland crop but will be reclaimed with native grass. (b) There are no permanent man-made structures within two hundred (200) feet of the affected area. (c) There are no natural water resources in the proposed area. (d) A wildlife statement is not required per Rule 6.3.2 for a Section 110 Permit. EXHBIT C: Mining Plan (a) The timing for the process is hard to estimate at this time. The primary purpose for the mine for the supply of road surfacing aggregate for proposed highway and oilfield projects. The project is scheduled to commence construction in Summer, 2013. If that schedule is reality, mining operation would commence in early Summer, 2013, and continue sporadically for 5 to 10 years. However, if the road project is delayed or a different aggregate supplier is chosen, the mining operation will not commence until an alternate construction project is identified and the proper notifications will be issued. (b) The mined area will be replaced with topsoil removed from the mined area. Any available top soil removed before mining will be stockpiled directly adjacent to the mined area to be replaced as topsoil in the reclamation process. The post mining use has been determined by the landowner to be rangeland/grazing land, the current use id dryland crop. The topsoil spoil piles will be protected with silt fence at the toe of pile and any topsoil piles expected to sit more than six (6) months will be broadcast seeded with annual forage approved by the landowner. The reseeding will be completed between May 1, 2013, and October 1, 2013. The seed will be drilled with a grass drill at 0.5 inch depth. The grass varieties are native and currently readily available from area seed companies. If the Owner's choice of reclamation is for range, the land shall be restored to slopes commensurate with the proposed land use and shall not be too steep to be traversed by livestock. (c) The mined material is predicted to range from sand similar to beach sand to nominal gravel up to 2 inch in size. Our interviews with the landowner have us believe the deposit to be as deep as 15 feet from grade and generally be increasingly coarse as toward the bottom deposit. The overburden is quite sandy, from 6 to 12 inches deep, and sometimes hard to distinguish from the cleaner sand it transitions to. Below the gravel deposit is a hard clay layer. (d) The thickness of the deposit to be mined is expected to be up to 20 feet. (e) The major mining components of the mining operation are access routes including Weld County Roads 124 and 127, the actual pit to be developed, and portable processing facilities to include an excavator with a 3 to 6 CUYD bucket, dozer, payloaders, crusher, screen plant, and conveyors that transport aggregate. (f) The pit excavation, mine benches, impoundments, stockpiles, etc. will be less than 10 acres. (g) The existing roads that will be used during the mining process are already established, Roads Weld County Roads 124 and 127. There will be no new construction of roads. (h) There will be a very limited amount of water used in this particular mining pit. Any water used will be delivered from our own water trucks. It is not expected to encounter any water in the mining process. (i) Any water encountered in the mining process will drain back to the mined area, and the plans for the gravel operation to be dry. (j) There is no issue of water rights related to this particular gravel permit. (k) There will be no chemicals involved. (I) Because the mine will be a depression to the adjacent topography, no storm water runoff is likely. There will be no traffic outside of the mine area except for the previously established access roads. The reclamation will have slopes from grade to the depression floor that will allow the reestablishment of native grasses. (m) The deposit will be processed on site. We will use a screen plant and possibly a crusher in a closed circuit to process road surfacing material similar to CDOT class 7 road surfacing gravel. (n) The primary commodity to be produced is road surfacing gravel. (o) We do not anticipate any secondary commodities to be produced at the site. (p) There will be no use of explosives planned or anticipated. EXHIBIT D: Reclamation Plan (a) After the mined deposit is removed, the mining equipment will be removed from the area before the reclamation commences. Normally this will occur 30 to 60 days after mining is complete. The estimated time of reclamation will run around 3 days per acre. This will include moving the material into the mined area, compaction of fill, and grading the areas to finish grade. It will take about 1/2 day per acre to conduct any straw mulching, fertilization and seeding. If we are within the Nov. 1 to May 1 timeframe, we will proceed to seed grass immediately as the final phase of the restoration process. (b) The topsoil will be piled with 3:1 slopes and silt fence placed at the foot of the pile. If the topsoil pile is expected to sit for periods greater than six (6) months, a summer annual plant may be broadcast to vegetate the pile in consultation with the landowner. (c) (i) We will use all available existing topsoil to reclaim the mine site. The existing topsoil is from 6 to 12 inches in depth, so the reclaimed mine site will be some fraction of the existing because of the 3:1 side slopes creating more surface area than at present. (H) The mine will be reseeded at the completion of the mining process. The topsoil will be spread with scrapers, bladed to grade with a motor grader, and then chiseled or disked to prepare the seed bed before drilling the seed. The date of the seeding will comply with the Nov. 1 to May 1 seeding period recommended by the NRCS. (Hi) The grasses included in seed mix are as follows per NRCS recommendation: a) Prairie Sandreed b) Sand Bluestem c) Switchgrass d) Blue Grama e) Needleandthread f) Sun Sedge (iv) The grass will be seeded 0.5 inches deep using a grass drill between May and November of the year following the termination of the production at the gravel pit. We will spread dry fertilizer before seeding using the USDA NRCS recommended application rate of 40 pounds nitrogen and 40 pounds phosphorous applied per acre of reclaimed land. The revegetation will only include drilling the above grass seed mix. There will be no trees, shrubs, or other plants planted in the reclaimed area. We plan to replace the mined areas with any available topsoil that is removed before the mining process. We are predicting topsoil depths of 6 to 12 inches, quickly transitioning to sand. Any noxious weeds encountered in the mining or reclamation process will be sprayed to prevent any noxious weed infestation. (v) The mulch that will be used will be straw. The crimping method is with a coulter machine and the rate of application will be one ton of straw per acre. (d) There are no ponds, streams, roads, buildings, that will be affected during reclamation. (e) There will be no waste rock to deal with as it will all be crushed in the production of road base. Furthermore, there are no underground mine openings, ditches, sediment control facilities (except the silt fence removed from base of stripped topsoil), buildings or other features not previously discussed. (2) Estimate of actual costs to reclaim the site based on what it would cost the State of Colorado using an independent contractor to complete reclamation: Backfilling: Estimate 10 acres topsoil, 6 inches thick, equal to 8,066 cubic yards backfilled. Topsoil will be placed at $1.25 per cubic yard: 8,066 CUYD times $1.25, equals $10,082.50. Grading: Grading slopes to 3:1 and final grade on placed topsoil, estimate 30 hours at $125 per hour, equals $3,750. Topsoil Application: Chisel 10 acres with a tractor and cultivator; estimate 2 hours at $150 per hour equals $300. Seeding: Seed cost and price of drilling seed at $250 per acre times 10 acres equals $2,500. Mulching: Straw cost of $100 per ton delivered to site plus spreading equals $200 per acre times 10 acres equals $2,000. Fertilization: Application of 40 pounds N and Pat $65 per acre equals $650. Labor: The cost of labor for the site restoration is included in the machine rates above. Estimated total cost of restoration is $19,282.50. S3NILi'd39 30 SISd9 AM' ill .014 C) O 0 O n to a cb 7, cc c21/4 c J O O ntn Yap d' tee Cl, ri Lu 1 x t I At9 elS .w ,tr�s�c I _ sin, a 4)E SDNIed32 30 SISY8 ,W cslaa AOC AC -ON MOzw Arun M V cvs AVG Ac at/ - TN ,tram 3.ot,c►471 %se -a EXHIBIT F: List of Other Permits and Licenses Required 1. Air Pollutant Emission Notice (APEN) and Application for Construction Permit And Fugitive Particulate Emissions Control Plan. 2. Access Permit Application for all points of ingress and egress onto County maintained roadways. 3. Colorado State Historical Preservation Office clearance (We have been informed that if there is no federal nexus for this project, but there is oversight from the Colorado Division of Reclamation Mining Safety (DRMS), that DRMS normally contacts the Colorado State Historical Preservation Office during the application review). 4. The proposed site for the gravel permit will be a dry pit and is far from a natural river, thence the ground water table should not be encountered by the operation. The mining operation will not expose any groundwater. There will not be any pollutants discharged into any State waters. 5. The proposed gravel site is not located on any federal lands or U.S. Forest Service. 6. Weld County Colorado Planning does not permit Section 110 Permits. Proof of evidence of the State permit will be submitted to the Planning office for their files. 7. Any other permit that would be required that we have not identified at this time. EXHIBIT G: Source of Legal Right -to Enter This LEASE, made in duplicate, this _28th_ day of _December , 2012, by and between Janyce Harmsherinafter LESSOR, and PINE BLUFFS GRAVEL and EXCAVATING, Inc, hereinafter, LESSEE. 1. LEASED PREMISES AND TERM LESSOR, in consideration of the rents, covenants and agreements of LESSEE, hereinafter set forth, and in consideration of each and every act to be done by the parties hereto, does by these presents exclusively let, lease and rent to LESSEE for a term of five (5) years from the date of this LEASE or until terminated as herein provided, a certain tract of land described as follows: Section 34, township 11 North, range 58 West, 61h principle meridian, Weld County Colorado, hereinafter referred to as PREMISES, for the purpose of mining and storing dirt, sand, gravel, and rock, hereinafter MATERIAL. The LESSEE shall have the right to extend this LEASE for an additional term of five (5) years by giving the LESSOR a written notice of such extension sixty (60) days previous to the expiration of the original five year term of this LEASE. 2. LESSOR'S WARRANTIES LESSOR warrants that she has marketable tide to the PREMISES and authority to enter into this LEASE and so dispose of the MATERIAL deposits located on the PREMISES. 3. LESSOR'S COVENANTS LESSOR agrees LESSEE may obtain a Title Search on the PREMISES. If the title search show there is a mortgage on the PREMISES, LESSOR shall furnish to the LESSEE a copy of the mortgage and agrees to obtain a signed mortgagee's waiver of royalty payments, or in lieu thereof, written instructions from the mortgagee and LESSOR for payment of the royalty. 4. LESSEE'S USE OF THE PREMISES LESSEE shall have the exclusive right and authority to go upon said PREMISES with its employees, trucks and machinery and such other equipment as may be necessary for the purpose of mining and removing from the PREMISES all MATERIAL as LESSEE may desire. LESSEE, shall have full and complete access to any sand, gravel, and rock pits over and across the PREMISES of the LESSOR, including the right of ingress and egress thereto and therefrom for only those activities directly related to the mining of aggregate materials from the PREMISES. LESSEE shall have the further right, if it so desires, to erect and maintain on PREMISES, at its own cost and expense, such machinery and equipment as it shall deem necessary for the proper and economical working of said pit or pits and the removal of MATERIAL therefrom. LESSEE shall have the right to remove, if necessary, and where LESSEE may consider advisable, any soil, waste sand or overburden from such MATERIAL and to deposit the same on PREMISES. 5. ENVIRONMENTAL CARE OF PREMISES LESSEE shall not bury or cause to be buried any trash or debris on the PREMISES. If the LESSEE should cause hazardous materials to be disposed of on the PREMISES, the LESSEE shall be responsible for cleanup of the contaminated area at LESSEE'S expense, regardless of the time frame which may be required by any governmental authorities supervising the elimination of the contamination, even though such elimination may extend beyond the term of this LEASE. LESSEE shall remove all dirt, sand rock, or other material brought onto the PREMISES when LESSEE has completed its mining operations on the PREMISES. 6.TERMINATION LESSEE may terminate this LEASE before the end of the LEASE term if LESSEE has completed its excavation operations on the PREMISES.LESSEE shall be deemed to have completed LESSEE'S operations when, in LESSEE'S sole discretion, further excavation of MATERIAL would no longer be economically desirable to LESSEE either because of the quantity or quality or location of the remaining deposits of the MATERIAL. 7.PAYMENT FOR MATERIAL LESSEE shall pay or cause to be paid to the LESSOR an amount of Forty (0.40) cents per ton of MATERIAL removed from the PREMISES. Such payment will be made to the LESSOR or any other person or entity at a time or place as so designated by the LESSOR. Payment from the LESSEE to the LESSOR shall be made by the _10th_ day of the month following removal of the MATERIAL, from the PREMISES. Claims for payment for the MATERIAL made by other parties shall not be the responsibility of the LESSEE. 8. LESSEE ADDITIONAL PREMISES USE LESSEE shall have the right to bring onto thereafter to remove from the PREMISES dirt, rock or other MATERIAL which may be used in the formulation of the final product produced. All tonnages of such product shall be separately accounted for when leaving the PREMISES. No royalty or any other compensation shall be paid by the LESSEE to the LESSOR for dirt, sand, rock or other MATERIAL which may be brought on the PREMISES. The LESSEE may require additional help from other contractors to fulfill aggregate mining requirements. The LESSOR does agree to allow LESSEE -approved contractors to enter and work on the PREMISES. 9.LESSOR USE OF THE PREMISES LESSOR shall have the unrestricted use of the PREMISES for any and all purposes except for the production, stockpiling, processing and shipment of sand, gravel and rock therefrom during the term of this LEASE. 10. LESSEE'S REMOVAL OF EQUIPMENT Upon the termination of this LEASE, whether by lapse of time or by termination because of completion of operation, or otherwise, LESSEE shall have the right and obligation to take and remove from said PREMISES any and all machinery and equipment belonging to LESSEE within 90 days of termination. 11. TAXES LESSOR agrees to pay before delinquency all taxes and special assessments levied with respect to the PREMISES during the term of the LEASE or any extension thereof. 12. WRITTEN MODIFICATION ONLY No action of any of the parties hereto shall be construed as an extension of the term of this LEASE or creation of a new agreement unless the same is in writing and signed by the parties hereto. 13. INSURANCE AND INDEMNITY LESSEE will at all times during the term of this LEASE, at their own cost and expense, insure and keep in effect on the real property such public liability insurance in the amount of $1,000,000 to insure LESSOR and LESSEE against all claims, demand or actions for injuries to or death of any one person, and for injury to or death of more than one person in any one accident. Provided, however, LESSOR and LESSEE shall cross -indemnify, protect and hold each other and their successors, heirs and assigns harmless from and against all damages, claims, attorney fees and demands arising out of the use of the PREMISES. 14. RELATIONSHIP OF PARTIES LESSEE shall in no event be construed for any purposes to be a partner, joint venture or associate of LESSOR or any sub -lessee, concessionaire, operator, or licensee of LESSOR with respect to the PREMISES. 15. LAND CONFORMATION AFTER MINING No mining of the PREMISES shall occur closer then fifty (50) feet of the property line of the PREMISES. After mining is completed the PREMISES will be left in a physical condition, which is pleasing to the eye and shall not be a hazard to cattle or the use of the property by the LESSOR. 16. CONTINGENCY LESSEE is not obligated to perform unless all of LESSOR'S obligations under the terms of this LEASE have been fulfilled. 17. SUCCESSORS AND ASSIGNS This LEASE shall be binding upon and inure to the benefit of the respective heirs, representatives, successors and assigns of the parties hereto. IN WITNESS WHEREOF the parties have executed and caused the due execution hereof respectively of duplicate copies, both of which shall be deemed originals as of the day and year above written. LESSEE: Janyce H /.fitt dciu li'Q4A?G0 l I / esSee Aa 5 P o/ ? ern,`t'a an s L es GA o?erafCy.. of 5 ra, l L1; :1„ -two years Prven kit- O -C Feo. 5-C' O. r•eer ewe + S �err�ih A. ` r'r �t f� �ei"ove vh �roce5sc�k 2-) Lessor red-rl�S Co( r5m-..et t u Se o-+ e,LeLrjeo01L • N EXHIBIT H: Municipalities Within a Two-mile Radius The closest municipality to the proposed gravel pit is Grover, Colorado. However, it is past the two-mile radius requirement. EXHIBIT I: Proof of Filing with County Clerk EXHIBIT J: Proof of Mailing of Notices to Board of County Commissioners and Soil Conservation District EXHIBIT L: Permanent Man -Made Structures There are no permanent man-made structures in the proposed mine site. An example Structure Agreement which meets the requirements of the Statutes is shown below. Structure Atreement This letter has been provided to you as the owner of a structure on or within two hundred (200) feet of a proposed mine site. The State of Colorado, Division of Reclamation, Mining and Safety ("Division") requires that where a mining operation will adversely affect the stability of any significant, valuable and permanent man-made structure located within two hundred (200) feet of the affected land, the Applicant shall either: a) Provide a notarized agreement between the Applicant and the Person(s) having an interest in the structure, that the Applicant is to provide compensation for any damage to the structure; or b) Where such an agreement cannot be reached, the Applicant shall provide an appropriate engineering evaluation that demonstrates that such structure shall not be damaged by activities occurring at the mining operation; or c) Where such structure is a utility, the Applicant may supply a notarized letter, on utility letterhead, from the owner(s) of the utility that the mining and reclamation activities, as proposed, will have "no negative effect" on their utility. ( Construction Materials Rule 6.3.12 and Rule 6.4.19 & Hard Rock/Metal Mining Rule 6.3.12 and Rule 6.4.20) The Colorado Mined Land Reclamation Board ("Board") has determined that this form, if properly executed, represents an agreement that complies with Construction Materials Rule 6.3.12(a), Rule 6.4.19(a), and C.R.S. § 34-32.5-115(4)(e) and with Hard Rock/Metal Mining Rule 6.3.12(a), Rule 6.4.20(a), and C.R.S. § 34-32-115(4)(d). This form is for the sole purpose of ensuring compliance with the Rules and Regulations and shall not make the Board or Division a necessary party to any private civil lawsuit to enforce the terms of the agreement or create any enforcement obligations in the Board or the Division. The following structures are located on or within 200 feet of the proposed affected area: N/A 1. 2. 3. 4. 5. (Please list additional structures on a separate page) Hello