2015-01-23_PERMIT FILE - P2015001 ‎(2)‎

• Permit No: P2015001
• IBM Index Class Name: PERMIT FILE
• Doc Date: 1/23/2015
• Doc Name: NOI application - Form 2
• From: The Eureka Mining CO, LLC
• To: DRMS
• Email Name: RCO
• Email Name: GRM
• Media Type: D
• Archive: No

(Form 2 - (Public File)
This form has been approved by the Mined Land Reclamation Board pursuant
to section 34 -32 -113, C.R.S., of the Mined Land Reclamation Act. Any
alteration or modification of this form shall result in voiding any NOI
issued on the altered or modified form and subject the operator to cease
and desist orders and civil penalties for operating without a NOI
pursuant to section 34 -32 -123, C.R.S.
I, the undersigned, being the NOI holder or the person authorized to sign
on behalf of the NOI holder, declare that the information given in this
NOI form is true and correct.
SIGNATURES MUST BE IN BLUE INK
Signed and dated this day of,
Signature of NOI holder or person authorized to sign:
Name (type or print)
Jim Fine
Title /Position:
Managing Member of The Eureka Mining Company, LLC