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STATE OF COLORADO <br />DIVISION Of RECLAMATION, MINING AND SAFETY <br />Deparknent d Natural Resou><es <br />1313 Sherman SL, Room 215 COLORADO <br />Denver, Colorado 80203 DIVISION OF <br />Phorre: (303) 8663567 @@PV RECLAMATION <br />FAX: 003) 832.8106 MINING <br />— &— <br />SAFETY <br />LBUM 114PACT OPERATION (110(2)) <br />RECLAMATION PERMIT <br />APPLICATION FORM <br />CHECK ONE:ZA-J,any <br />iarti 1.4} -ElConversion Application (Rule 1.11) DEL' 2 2 �� rs <br />�n/15lON OF <br />Z01 (provide rconversionsofexisting permits) MINING$ EC�MRT10�4F NThe li 'eg Operation Reclamation Permit contains three major parts: (1) the appon <br />forte (2) Fxtubiquired sections of Exhibit S and Geotechnical Stability Exhibit, as required by the Office, and outliticd in <br />Rules 6.1, 62, 6.3, 6.4.19 and 6.5; ar (3) the application fee. When you submit your application, be sure to include one (1) sionxi and <br />notarized original and one (1) copy of the application farm, two (2) copies of Exhibits A -J, appropriate sections of 6A. 19 Exhibit S and 6.5 <br />(Geotechnical 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; craps should be folded to 8 112" X 11" or 8 112" X 14" size. 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 below <br />1. ARRUcluttoperator or company name to be used on the Permit): CRG Mining LLC <br />1.1 Type of organization (corporation, partnership, etc.): limited liability company <br />2. Operation name fait. mine or site name <br />3. Permitted acreage (new or existing site): <br />4. Fees: <br />4.1 New Application <br />Sacramento Access Tunnel <br />4.2 Amendment Application (from 1.10(2)) <br />4.3 Conversion Fee (from 110d to 110(2), (Rule 1.11.2(2)) <br />5. Primary commoditie(g) to be rtrined: <br />Gold, silver <br />6. Name of owner to the surface of affected lam <br />Gold Links Mining Corp. <br />5.55 permitted acres <br />51M6.QQ� application fee <br />1.7 .QQconversion fee <br />7. Name of owner to the subsurface rithts of affected land: Gold Links Mining Corp. <br />8. 1�Gpe of mining operation. 11 Surface Underground In-situ <br />Office of Office of <br />Mitred Land Reclamation Denver • Grand lunction • Durango Active and Inactive Mines <br />