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McENDAFFER MINE 112 RECLAMATION PERMIT APPLICATION <br /> Exhibit R - Proof of Filing with County Clerk and Recorder <br /> 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 COLORADO <br /> Phone:(303)866-3587 DIVISION OF <br /> FAX (303)832-8106 RECLAMATION <br /> MINING <br /> SAFETY <br /> CONSTRUCTION MATERIALS <br /> REGULAR(112)OPERATION <br /> RE.CLAM.ATION PERMIT APPLICATION FORM <br /> CHECK ONE: There is a File Number Already Assigned to this Operation <br /> # M -20/0 -03/(Please reference the file number currently assigned to this operation) <br /> Permit <br /> New Application(Rule i.4.5) Amendment Application(Rule 1.10) <br /> is Conversion Application(Rule 1.11) <br /> Permit# M - -O.(provide for Amendments and Conversions of existing permits) <br /> The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts:(1)the application <br /> form;(2)Exhibits A-S,Addendum 1,any sections of Exhibit 6.5(Geotechnical Stability Exhibit;and(3)the application fee. When you <br /> submit your application, be sure to include one (1) complete signed and notarized ORIGINAL and one (1) copy of the completed <br /> application form,two(2)copies of Exhibits A-S,Addendum 1,appropriate sections of 6.5(Geotechnical Stability Exhibit,and a check for <br /> the application fee described under Section(4)below. Exhibits should NOT be bound or in a 3-ring binder;maps should be folded to <br /> 8 1/2"X 11"or 8 1/2"X 14"size. To expedite processing,please provide the information in the format and order described in this form. <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly,in the space provided,ALL information requested below. <br /> 1. Applicant/operator or company name(name to be used on permit): SYZYGY Enterprises , LLC <br /> i.1 Type of organization(corporation,partnership,etc.): LLC <br /> 2. Operation name(pit,mine or site name): McEndaffer Mine <br /> 3. Permitted acreage(new or existing site): 9.99 <br /> permitted acres <br /> 3.1 Change in acreage(+) _ 21.95 <br /> acres <br /> 3.2 Total acreage in Permit area 31.94 <br /> -- --_ - acres <br /> Page 23 <br /> 1.)?/d &/7:, (ki f ,6( -- <br /> `.J <br /> 4c,iu� �3/a5`/ o/(� <br /> C <br />