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Q V <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone; 003) 866.3567 <br />FAX: (303) 6328106 <br />STATE OF COLORADO <br />LIMITED IMPACT OPERATION (110(2)) <br />RECLAMATION PERMIT <br />APPLICATION FORNI <br />CHECK OKE: D New Application (Rule 1.4) _a Conversion Application (Rule 1 11) <br />Permit 4 M O j }_0_0_e (provide for conversions of existing permits) <br />COLORADO <br />D I vi S I O N of <br />RECLAMATION <br />MINING <br />SAFETY <br />MAR 112015 <br />DIVISION OF RECLAMATION <br />MINING AND SAFETY <br />The application for a Lintited Impact Designated Mining Operation Reclamation Permit contains diree major pans: (1) the application <br />form: (2) Exhibits ,44, any required sections of Exhibit S and Geotechnical Stability Exhibit, as required by the Office, and outlined in <br />Rules 6.1, 6.2, 6.3, 6,4. 19 and 6.5; an (3) the application fee. When you submit your application, be sure to include one (1) •igned an <br />notarized original and one (1) copy of the application form, two (2) copies of Exhibits A -J, appropriate sections of 6.4.19 Exhibit S and 6.5 <br />(Geotahnical Stability Exhibit), as required, and a check for the application fee described under (4) below. Exhibits should not be bound <br />or in a 3 -ring binder; reaps should be folded to R 1R" X I1" or R 1/2" X 14" sine. To expedite processing, please provide the information <br />in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described beloiN <br />1. AApalicantloperator or comaanv name (name to he used on the permlt)• Way Up High Mining Company, LLC <br />1.1 Type of organization (corporation, partnership, etc.): LLC <br />2. Operation name fait mine or site name)- Digging the Blues Lode <br />3. Permitted acreage (new or existing site): 8.96 permitted acres <br />4. Fees: <br />4.1 New Application S1,006.00 application fee <br />4.2 Amendment Application (from 1.10(2)) <br />4.3 Conversion Fee (from 110d to 110(2). (Rule 1.11.2(2)) 51.925.00 conversion fee <br />5. Primary commoditle(s) to he maned: Smoky Quartz and Aquamarine Gemstone Minerals <br />h. Name of owner to the surface of affected land: US Forest Service <br />7. Name of owner to the subsurface rights of affected land: Way Up High Mining Company. LLC CIVIC # 286476 <br />X, Type of mining operation 21 Surface F] Underground (n -situ <br />Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Office of <br />Active and Inactive Mines <br />