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Address Info: 1150 O Street, P.O. Box 758, Greeley, CO 80632 | Phone:
(970) 400-4225
| Fax: (970) 336-7233 | Email:
egesick@weld.gov
| Official: Esther Gesick -
Clerk to the Board
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20120377.tiff
STATE OF COLORADO DIVISION OF RECLAMATION,MINING AND SAFETY Department of Natural Resources V WELD COUNTY r 13t3 Sherman 56,Room 215 � - COMMISSIONERS Denver,Colorado 80203 COLORADO DIVISION OF Phone:(303)866-3567 FAX:(303)832-8106 2012 FEB .-b P 4: 01 RECLAMATION MIG -6t- RECEIVED SAFETY CONSTRUCTION MATERIALS - Bill Ritter,Jr. LIMITED IMPACT(110)OPERATION Governor Harris D.Sherman RECLAMATION PERMIT APPLICATION FORM Executive Director Ronald W.Cattany Division Director CHECK ONF: D There is a File Number Already Assigned to this Operation Natural Resource Trustee Permit# M - - - (Please reference the umber currently assigned to this operation) _E_New Application(Rule 1.4.5) 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(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-I,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 Ifl 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):5v P6 2.t i,& O It,P 1 EL b 56 V i cc S co-11TD 1.1 Type of organization(corporation,partnership,etc.): L.LLC 2. Operation name(pit,mine or site name): Na&` H J' (`'R, 3. Permitted acreage(new or existing site2: 3 aO permitted acres 3.1 Change in acreage(+) acres 3.2 Total Acreage in Permit Area 330 acres 4. Fees: 4.1 New Application: $1158.00 application fee Amendment Fee(C.R.S.34-32.5-125(11)): S827.00 application fee 4.2 Conversion Fee(from 110d to 110 S2,696.00 conversion fee(Rule 1.11.2(2)) 5. Primary commoditie(s)to be mined: b RAO— D)rT 5.1 Incidental commoditie(s)to be mined: 1. / lbs/Tons/vr 2. / lbs/Tons/yr 3. / lbs/Tons/vr 4. / lbs/Tons/yr 5. / lbs/Tons/vr 5.2 Anticipated end use of primary commoditie(s)to be mined: KOI4rD CoVb"T1?UCT"161A AMU,)14 PAD Co n5T Anticipated end use of incidental commoditie(s)to be mined: Office of Office of Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines Qk-JOLa(, 4-1/4);EL,; Cc;. PU', PI. 2012-0377 - I3 ( a -2- 11. Correspondence Information: APPLICANT/OPERATOR (name,address,and phone of name to be used on permit) Contact's Name: Mkt MK- (' DAL-12 Title: Pus l p C-Air Company Name: 5VPE&WIL 661,FlGL-1) 5€-A ViLLS cot , LTD Street/P.O. Box: 14.).Z OK R-D. P.O.Box: '33‘35-1., City: (105-,LC-ti State: CD Zip Code: 80633 Telephone Number: ( 'ip }o )- 45-14- 3t),a1 -6 Fax Number: I i-o )- H&4-1 - R-)-3 PERMUTING CONTACT (if different from applicant/operator above) Contact's Name: Title: Company Name: Street/P.O.Box: P.O.Box: City: State: Zip Code: Telephone Number: f )- Fax Number: f )- INSPECTION CONTACT Contact's Name: M l C 1k A EL- 111 ll,L Eit. Title: PIES 1 P E Air Company Name: supeKIoY. Ott-FIELD 5U-VICES Co- ) LTD Street/P.O. Box: (''12.70 GC �a- P.O. Box: 3363,5-6 City: State: CV Zip Code: tot2Zi'3 Telephone Number: ( 1- Fax Number: ( 1- CC: STATE OR FEDERAL LANDOWNER(if any) Agency: Street: City: State: Zip Code: Telephone Number: ( )- CC STATE OR FEDERAL LANDOWNER(if any) Agency: Street: City: State: Zip Code: Telephone Number: f )- -3- 7. Name of owner of the subsurface rights of affected land: 8. Name of owner of the surface of affected land: K,0 i'd w- Air CO. 9. Type of mining operation: Surface Underground In-situ 10. Location information: The center of the area where the majority of mining will occur: COUNTY: VJtC D PRINCIPAL MERIDIAN(check one): 1 N 6th(Colorado) ® 10th(New Mexico) El Ute SECTION(write number): S TOWNSHIP(write number and check direction): T l a ® North 11 South RANGE(write number and check direction): R b3 East n� West QUARTER SECTION(check one): El NE 11 NW SE 17 SW QUARTER/QUARTER SECTION(check one): El NE El , NW El SE El SW GENERAL DESCRIPTION:(the number of miles and direction from the nearest town and the approximate elevation): e MIL£5 Lua5T /Y)'tD I MILE. AIDILTH OF HILtt FO2-13 CO 5439 ' II. 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 min sCik sec Jk. 36 (2 decimal places) Longitude(W): deg 1D4 min 43 sec 3`I-, S3 (2 decimal places) OR Example: (N) 39.73691° (W) -104.98449° Latitude(N) (5 decimal places) Longitude(W) (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 Zone 13 Easting Northing -4- 12. Primay ,future(Post-mining)land use(check,DM1: .L Cropland(CR) — Pastureland(PL) General Agriculture(GA) Rangeland(RL) — Forestry(FR) Wildlife Habitat(WL) — Residential(RS) — Recreation(RC) lndustrial/Commercial(IC) Developed Water Resources(WR) Solid Waste Disposal(WD) 13. Prim resent land use(check one): I L�J Cropland(CR) 1 Pastureland(PL) General Agriculture(GA) Rangeland(RL) Forestry(FR) Wildlife Habitat(WL) Residential(RS) nRecreation(RC) ( Industrial/Commercial(IC) Developed Water Resources(WR) 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: 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) -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)(V III). 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-I 15(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-I 15(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 34-32.5-1IO,C.R.S.,of the Colorado Land Reclamation Act for the Extraction ofConstruction Materials. Any alteration or modification of this form shall resukin 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. Signed WI � and 10 /�-dayof aAt( Jo1 D'A � St/ai l 06(6:0 If Corporation Attest(Seal) Applicant/Operator �}�/s�.fi t/i[LS to, Signe0: L'-t,J�``I V U.�"t Signed: (� c_ Corporate Secretary or Equivalent Y Title: G'ZG� 10 l✓Jt Town/City/County Clerk State of Lillimcto ss. County oft i)C)CA i- The foregoing instrument was acknowledged befo a me this CA' day of }ihitio fl,I ,J CC__ byYYI�LY\Qet 1"rl�(1Pr' as ridol1� ts�o4Pr';1Y NI- arid c.JefteiL'P`J Notary Public • TARA BRISBY My Commission expires: A a-16/6- Notary Public State of Colorado SIGNATURES MUST BE IN BLUE INK My Commission Expires January 06,2015 An example Structure Agreement which meets the requirements of the Statutes is shown below. Structure Agreement 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 64.19(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: 1. WO SIj WC-ivRLS 2. 3. 4. 5. (Please list additional structures on a separate page) CERTIFICATION The Applicant, (print applicant/company name), by (print representative's name), as (print representative's title), does hereby certify that (structure owner) shall be compensated for any damage from the proposed mining operation to the above listed structure(s) located on or within 200 feet of the proposed affected area described within Exhibit A,of the Reclamation Permit Application for (operation name), File Number M- - This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its authority under the Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado Mined Land Reclamation Act for Hard Rock,Metal, and Designated Mining Operations. Any alteration or modification to this form shall result in voiding this form. NOTARY FOR PERMIT APPLICANT ACKNOWLEGED BY: Applicant Representative Name Date Title STATE OF ) ) ss. COUNTY OF ) The foregoing was acknowledged before me this day of , 20 ,by as of My Commission Expires: Notary Public NOTARY FOR STRUCTURE OWNER ACICNOWLEGED BY: Structure Owner Name Date Title STATE OF ) ) ss. COUNTY OF The foregoing was acknowledged before me this day of , 20 ,by as of My Commission Expires: Notary Public INFORMATION AND EXHIBITS FOR 110 APPLICATION OF SUPERIOR OILFIELD SERVICES CO., LTD, GREELEY COLORADO EXHIBIT B SITE DESCRIPTION The site is remote rangeland on the Colorado Wyoming border in northern Weld County Colorado 4 miles west and 1 mile north of Hereford Colorado. The site is currently in wheat production in alternate years. The site is level and borders on a drainage to the west. EXHIBIT C MINING PLAN The mining plan is to develop 10 acres on the southern boundary of the property for mining purposes. When this 10 acres is exhausted the 10 acres will be covered in topsoil and reseeded into farm production or pasture. If sales justify conversion at that time the permit will be converted into a 112 permit. EXHIBIT D RECLAMATION PLAN When a mining cell is completed it will be covered in topsoil and reseeded into farm production or pasture at the landowners direction. EXHIBIT F LIST OF OTHER PERMITS AND LICENSES REQUIRED 1. Use by Special Review Weld County Colorado 2. APEN for crusher, screen, generator 3. Fugitive dust permit EXHIBIT G Weld County has agreed to provide a non-exclusive right of way agreement to use undeveloped county right of way for access. Superior has a lease agreement with the property owner allowing use of the subject property, a copy of which is attached. EXHIBIT H There are no municipalities within a 2 mile radius of the subject property. NOTICE OF FILING APPLICATION FOR COLORADO MINED LAND RECLAMATION PERMIT FOR CONSTRUCTION MATERIALS LIMITED IMPACT(110)OPERATION NOTICE TO THE BOARD OF COUNTY COMMISSIONERS W�I— COUNTY Sv FL)L Ioik b I t,FIE L D Sf LV IC.15 CD•)(the Applicant/Operator")has applied for a Construction Materials Limited Impact (110) Reclamation permit from the Colorado Mined Land Reclamation Board (the "Board") to conduct the extraction of construction materials in V1/4/11--D County. The attached information is being provided to notify you of the location and nature of the proposed operation. The entire application is on file with the Division of Reclamation,Mining,and Safety(the"Division")and the local county clerk and recorder. The applicant/operator proposes to reclaim the affected land to A U2-t W L1U ILfL use. Pursuant to Section 34-32.5-116(4)(m),C.R.S.,the Board may confer with the local Board of County Commissioners before approving of the post-mining land use. Accordingly,the Board would appreciate your comments on the proposed operation. Please note that, in order to preserve your right to a hearing before the Board on this application, you must submit written comments on the application within ten(10)days after the date of the applicant's newspaper publication. If you would like to discuss the proposed post-mining land use,or any other issue regarding this application,please contact the Division of Reclamation, Mining, and Safety, 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303)866-3567. NOTE TO APPLICANT/OPERATOR: You MUST attach a copy of the application form to this notice. If this is a notice of a change to a previously filed application you must either attach a copy U.S. Postal Service.rr description of the change. CERTIFIED MAIL.., RECEIPT rru (Domestic Mail Only;No Insurance Coverage Provided) Er F•r •ePv"ry lnf•rmatl•n visit .ur we•site at www.us.s.c•ms, Ln Postage $ corned Fee Return Receipt Fee V Pos CI (Endorsement Required) tit �G (�`. Here Restricted 0 (Endorsemeelivery Fee nt Required) GG Q �)`) 20\2 LnH Total Postage&Fees $ $3' 02/06/201? rq nt To tilt-LP a U Will i� 49S taI%1. o Street,P xNo.t p.D r I„Dg. Ts? f` SeetO Box No. CM:State.Z/P+,IJt.C, r r, w 87)6,3) l .. . . . _._ NOTICE OF FILING APPLICATION FOR COLORADO MINED LAND RECLAMATION PERMIT FOR CONSTRUCTION MATERIALS LIMITED IMPACT(110)OPERATION NOTICE TO THE BOARD OF SUPERVISORS OF THE LOCAL CONSERVATION DISTRICT Wbr j,c%.LffrA cer 9c 46111 E' DISTRICT TD 5r/ILt<•ivx. ou,Fi(� 5LLVICL5 0` �" (the "Applicant/Operator")has applied for a Construction Materials Limited Impact (110)Reclamation permit from the Colorado Mined Land Reclamation Board(the"Board")to conduct the extraction of construction materials in 1.-4/1240 County. The attached information is being provided to notify you of the location and nature of the proposed operation. The entire application is on file with the Division of Reclamation, Mining,and Safety(the"Division")and the local county clerk and recorder. The applicant/operator proposes to reclaim the affected land to AUL IC vu f1 nut tr use. Pursuant to Section 34-32.5-116(4)(m),C.R.S.,the Board may confer with the local Conservation Districts before approving of the post-mining land use. Accordingly,the Board would appreciate your comments on the proposed operation. Please note that,in order to preserve your right to a hearing before the Board on this application,you must submit written comments on the application within ten(10)days after the date of the applicant's newspaper publication. If you would like to discuss the proposed post-mining land use,or any other issue regarding this application,please contact the Division of Reclamation, Mining, and Safety, 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303)866-3567. U.S. Postal Service, CERTIFIED MAILTM RECEIPT NOTE TO APPLICANT/OPERATOR: You must attach a copy of them (Domestic Mail Only;No Insurance Coverage Provided) a change to a previously filed application you must either attach a cop a F r•slivery Int•rmatl•n visit •ur we•site at www.us•s.c•mm description of the change. GOLF L 4a34'LO u, r_4 _ Lti Postage $ $0:65';`--' 0 0401 Certified Fee + ` c2• � mV Postmark Return Receipt Fee I 0 (Endorsement Required) $c J V re�'1 © Restricted Delivery Fee J cP a (Endorsement Required) $0, 0 in .-q Total Postage&Fees $ n -401 Sent To r_"4 bi't MCw'C CAKSEKikeT )1ti Street,Bt. .:k3va wta=s7ILD - City,State,ZlPs4 SF rm 3'n Au•ust2n See•-versef•rinst c .ns LARGE MAPS AVAILABLE FOR VIEWING AT THE CLERK TO THE BOARD 'S OFFICE , IN THE PUBLIC REVIEW FILE .
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