2014-05-20_REVISION - M1997039

• Permit No: M1997039
• IBM Index Class Name: REVISION
• Doc Date: 5/20/2014
• Doc Name: Conversion application CN01
• From: Wyatt Redi-Mix Co.
• To: DRMS
• Type & Sequence: CN1
• Email Name: TAK
• Email Name: PSH
• Media Type: D
• Archive: No

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Two (2) complete, unbound application packages must be submitted. One complete application package consists of a signed appheat m
form and the set of maps and exhibits referenced below as Eadubits A-S, Added 1, and the Geotechnical Stability Exhibit Eachaddibit
within the won must be presented as a separate section_ Begin each exhibition anew page Pages should be numbered consecutively
for ease of referees if separate documents are used as appendices, please reference these by name in the exhibiL
With each of the two (2) signed application forras, you mica submit a corresponding set of the maps and exhibits as described in the
following references to Rule 6.4, 6-5, and 162(l)(b):
EXHIBIT A
Legal Description
EXHIBIT B
Index Map
EXHmIT C
ProUiring and M'ming Plan Map(s) of Affeded Lands
EXHIBIT D
Mining Plan EXHIBIT
EXHIBIT E
Reclamation Plan
EXHIBIT F
Reclamation Plan Map
EXMIT G
Water Information
E)GMff H
Wildlife Information
EXHIBIT I
Soils Information
EXHIBIT J
Vegetation Information
EXHIBIT K
Climate Information
EXHIBIT L
Reclamation Costs
EXHIBIT M
Other Permits and Licenses
EXHIBIT N
Source of Legal Right To -Enter
EXHmrr O
Owners of Record of AffaXed Land (Surface Area) and Owners of Substance to be Mimed
EXHIBIT P
Municipalities Within Two Wiles
EXHIBIT Q
Proof of Marling of Notices to County Commissioners and Conservation District
EXHIBIT R
Proof of Filing with County Clerk or Recorder e
EXHmIT S
Permanent Man -Made structures
Rule 1.6.2(l)(b)
ADDENDUM I - Notice Requirements (sample enclosed)
Rule 6.5
Geatechnical Stability Exhibit (any requite )
The iastiuCWM ibr preparing Exhibits A-S, Added 1, and Geowclmical SiabUy EAubd are specified undr Rule 6.4 and 6S and
Rule 1.62(l)(b) ofthe Rules and Regulations. Ifyou have any quesfions on preparing the Exhibits or content ofthe infatmation required,
or would Hite to schedule a pr on meeting you may contact the Office at 303- 866-3567.
i.t T7.7, 1 is 11 ; _ id, i!
Upon application approval and permit ice, this application beoomes a legally binding document. T hoi- oM there are a
number of important requirements which you, as a permittee, should fully understand- These requirements are listed below.
Please mead and initial each requirement, in the space provided, to acknowledgethat you understand your obligations. If you
do not tmdughmd these obligations then please contact this Office fof a full explanation.
Your obligation to reclaim the site is not limited to the amount ofthe financial wa v anty- Yoee assow legal
for all reasonable expenses which the Board or the Office may incur to rechum trio aftoW lapds
/� assoc of ed with your mining operation in the event your permit is revoked and 5�ncial warren$! is f