2016-05-04_REVISION - M1986102

• Permit No: M1986102
• IBM Index Class Name: Revision
• Doc Date: 5/4/2016
• Doc Name: edited application AM01
• From: Colllins-Morehead LLC
• To: DRMS
• Type & Sequence: AM1
• Email Name: LJW
• Email Name: GRM
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION,MINING AND SAFETY RECEIVED
Department of Natural Resources
1313 Sherman St.,Room 215
Denver,Colorado 80203 MAY 0 4 2016C O L O R A D O
Phone:[phone] P M S IOW OF
ON
FAX:[phone] RE MINING
DIVISION OF RECLAMATION &
MINING AND SAFETY SAFETY
CONSTRUCTION MATERIALS
f LIMITED IMPACT(110)OPERATION
A ' ` 1 RECLAMATION PERMIT APPLICATION FORM
CHECK ONE: / There is a File Number Already Assigned to this Operation
Permit# I86 102 (Please reference the file number currently assigned to this operation)
New Application(Rule 1.4.5) l✓I Amendment Application(Rule 1.10)
Conversion Application(Rule 1.11)
Permit# M - 1986- 102 _ (provide for Amendments and Conversions of existing permits)
The application for a Construction Materials Limited Impact(110)Operation Reclamation Permit contains three major parts: (1)the
application form;(2)Exhibits A-J,Exhibit L,Addendum 1,any sections of Exhibit 6.5 and Geotechnical Stability Exhibit,as required by
the Office,and outlined in Rules 6.1,6.2,6.3,6.5,and 1.6.2(1)(b);and(3)the application fee. When you submit your application,be sure
to include one(1)complete signed and notarized ORIGINAL and one(1)copy of the completed application form, two(2)copies of
Exhibits A-J,Exhibit L,Addendum 1,and appropriate sections of 6.5(Geotechnical Stability Exhibit),as required,and a check for the
application fee described under(4)below. Exhibits should NOT be bound or in a 3-ring binder;maps should be folded to 81/2"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.
GENERAL OPERATION INFORMATION
Type or print clearly,in the space provided, ALL information described below.
1. Applicant/operator or company name(name to be used on permit): Dan Collins/Collins-Morehead, LLC
1.1 Type of organization(corporation,partnership,etc.): Limited Liability Partnership
2. Operation name(pit,mine or site name): Deep Creek Placer
3. Permitted acreage(new or existing site): 2.0 permitted acres
3.1 Change in acreage(+) acres
3.2 Total Acreage in Permit Area acres
4. Fees:
4.1 New Application: $1258.00 application fee
Amendment Fee(C.R.S. 34-32.5-125(II)): $827.00 application fee
5. Primary commoditie(s)to be mined: N/A
5.1 Incidental commoditie(s)to be mined: 1. N/A/ lbs/Tons/yr 2. / lbs/Tons/yr 3. / lbs/Tons/yr
4. / lbs/Tons/yr 5. / lbs/Tons/yr
5.2 Anticipated end use of primary commoditie(s)to be mined: N/A
Anticipated end use of incidental commoditie(s)to be mined: N/A
Annual Fee, Report and Map CW
\I No Violations