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� STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St„ Room 215 <br />Denver, Colorado 80203 <br />COLORADO <br />Phone: (303) gbh 356 <br />D OF <br />RECLAMATION <br />LAMATION <br />FAX: (303) 832$106 <br />MINING <br />SAF <br />SAF <br />SAFETY <br />REGULAR (112d) DESIGNATED MINING OPERATION <br />RECLAMATION PEWMIT <br />-R—EC- G, VED <br />APPLICATION FORM <br />W Z 17014 <br />1(kM('2-- U6=cFRB2A9X= <br />CHECK ONE: New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit No. M- 1977 .215 (provide for amendments and conversions of existing pernrits) <br />The application for a Regular (112d) Designated Mining Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A -T, Geotechnical Stability Exhibit, the Emergency Response Plan, and Addendum 1, as required by the Office, and outlined in Rules <br />6.1, 6.2, 6.3, 6.4.19, 6.5, 8.0, and 1.6.2(1)(b); and, (3) the application fee. When you submit your application, be sure to include one (1) signed and <br />notarized original and four (4) copies of the application form, five (5) copies of Exhibits A -T, Rule 6.5 Geotechnical Stability Exhibit, the <br />Emergency Response Plan, Addendum 1, and a check for the appropriate application fee (described under Section (4) on Page 2). Exhibits should <br />not be bound or in a 3 -ring binders; maps should be folded to 8 '' /s" X 1 i" or 8 ''A" X 14" size. To expedite processing, please provide the <br />information in the format and order described in this form. <br />2. <br />3. <br />GENERAL OPERATION ItiFORMATION' <br />Type or print clearly, in the space provided, all information described below. <br />Avolicantloverator or company name (name to be used on Dermit): <br />Rio Grande Silver, Inc. <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />1.2 I.R.S. Tax ID No. or Social Security Number: 26- 0715650 <br />Operation name (pit, mine or site name); <br />Permitted acreage: (new or existing site) <br />3.1 Change in acreage (+) <br />3.2 Total acreage in Permit area <br />AF & Report <br />No ViaWOns <br />568 permitted acres <br />0 acres <br />568 acres <br />twice Of Office of <br />Mined Land Reclamation Denver • Grand Junction a Durango Active and Inactive Mines <br />