2015-11-06_PERMIT FILE - C1981022 ‎(2)‎

• Permit No: C1981022
• IBM Index Class Name: Permit File
• Doc Date: 11/6/2015
• Doc Name: Colorado Oil And Gas Conservation Commission
• Media Type: D
• Archive: No

LEASE INFORMATION
I Using standard QtrQtr, Sec, Twp, Rng format, describe one entire mineral lease that will be produced by this well (Describe lease
beneath surface location if produced Attach separate description page or map if necessary.)
Please see attached description of lease.
Total Acres in Described Lease: 2858 Described Mineral Lease is. TX` Fee State Federal Indian
I Federal or State Lease #
Distance from Completed Portion of Wellbore to Nearest Lease Line of described lease: 420 Feet
CULTURAL DISTANCE INFORMATION
Distance to nearest:
Building:
Building Unit.
High Occupancy Building Unit:
Designated Outside Activity Area:
Public Road
Above Ground Utility
Railroad
Property Line
5280 Feet
5280 Feet
5280 Feet
5280 Feet
219 Feet
5280 Feet
130 Feet
220 Feet
DESIGNATED SETBACK LOCATION INFORMATION
Check all that apply. This location is within a: Buffer Zone
Exception Zone
Urban Mitigation Area
Pre -application Notifications (required if location is within 1,000 feet of a building unit):
Date of Rule 305 a (1) Urban Mitigation Area Notification to Local Government:
Date of Rule 305.a.(2) Buffer Zone Notification to Building Unit Owners:
S
D
D
F1
u"
Us -
INSTRUCTIONS:
-All measurements shall be provided from center of
the Proposed Well to nearest of each cultural
feature as described in Rule 303.a.(5).
Enter 5280 for distance greater than 1 mile,
Building - nearest building of any type. If nearest
Building is a Building Unit, enter same distance for
both.
- Building Unit, High Occupancy Building Unit, and
Designated Outside Activity Area - as defined in
100 -Series Rules.
- Buffer Zone — as described in Rule 604.a.(2), within
1,000' of a Building Unit
- Exception Zone - as described in Rule 604.a.(1),
within 500' of a Building Unit.
- Urban Mitigation Area - as defined in 100 -Series
Rules.
3ACING and UNIT INFORMATION
stance from Completed Portion of Wellbore to Nearest Wellbore Permitted or Completed in the same formation: 5095 Feet
stance from Completed Portion of Wellbore to Nearest Unit Boundary 420 Feet (Enter 5280 for distance greater than 1 mile.)
,deral or State Unit Name (if appl)- Elk Creek Unit Number: COC75003X
)ACING & FORMATIONS COMMENTS
3JECTIVE FORMATIONS
Objective Formation(s) Formation Code spacing Order Number(s) Unit Acreage Assigned to Well Unit Configuration (N12. SE/4. etc.)
CAMEO COAL CMEOC
DRILL —IN G
DRILLING PROGRAM
Proposed Total Measured Depth: 100 Feet
Distance to nearest permitted or existing wellbore penetrating objective formation: 5180 Feet (Including plugged wells)
Will a closed-loop drilling system be used? No
Is H25 gas reasonably expected to be encountered during drilling operations at concentrations greater than
or equal to 100 ppm? No (If Yes, attach an H2S Drilling Operations Plan)
Will salt sections be encountered during drilling? No
Date Run: 1011812013 Doc [#400469695] Well Name: Oxbow Mining LLC 2 Page 2 of 5