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Fq4 F ICOLORADO <br />1 Division of Reclamation,w` I Mining and Safety <br />1313 Sherman area, Roomn r 1'.i <br />Denver, CO 80203 <br />ERR W HE LIMITED IMPACT OPERATION(110(1))RECEIVED <br />RECLAMATION PERMIT <br />APPLICATION FORM FEB 0 6 2018 <br />CHECK ONE: _E_New Application DIVISION OF RECLAMATION, <br />MINING AND SAFETY <br />Permit M-2018-007 — (provide for conversions and amendments of existing permits) <br />The application for a Limited Impact 110(1) Mining Operation Reclamation Permit contains three major parts: (1)the application form; <br />2)ExhibitsA-J,any required sections of Exhibit S and Geotechnical Stability Exhibit,as required by the Office,and outlined in Rules 6.1, <br />6.2,6.3,and 6.5;and(3)the application tee. When you submit your application,be sure to include one(1)sieved and notarized original <br />and one(I)copy of the application form,two(2)copies of Exhibits A-J,and 6.5(Geotechnical Stability Exhibit),as required,and a check <br />for the application fee described under(4) below Exhibits should not be bound or in a 3-ring binder;maps should be folded to 8 1/2"X <br />11"or 8 1/2"X 14"size. •1'o 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 described below <br />1.Applicant/operator or company name(name to be used on the permit): Smash Brothers Explorations <br />1.1 Type of organization(corporation,partnership,etc.): LLC <br />2.Operation name(pit,mine or site name): Project P.J. <br />3.Permitted acreage(new or existing): (must be 5 acres or less) 4.95 permitted acres <br />4.Fees: <br />4.1 New Application 288.00 application fee <br />5. Primary cornmoditie(s)to be mined: Amazonite and Fluorite <br />6. Name of owner to the surface of affected land: U.S.F.S. <br />7. Maine of owner to the subsurface rights of affected land: U.S.F.S <br />n <br />8. Type of mining operation: C Surface I J Underground ['Placer <br />CJi C ilrj <br />O, <br />1313 Sherman Street, Room 215,Denver,CO 80203 P 303.866.3567 F 303.832.8106 http://rnining.state.co.us * 1'' <br />r