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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Dgmvnent of Natural Resoumes RE: M-2018-036 <br /> 1313 Sherman St.,Room 215 BLM CMC254209 <br /> •Colorado 8=3 USFS File Code 2810 D O L UI u N ROOF <br /> Phase 003)M&3567 RECLAMATION <br /> FAX(303)832.8106 USFS MPO-2018-004 MINING <br /> E at— <br /> Y <br /> LIMITED IMPACT OPERATION(110(2)) SAFETY <br /> RECLAMATION PERMIT <br /> APPLICATION FORM <br /> CHECK ONE: El New Application(Rule 1.4) Conversion Appli <br /> Permit#M- - (provide for conversions of existing pei <br /> The application for a Limited Impact Designated Mining Operation Reclamation Permit G )iication <br /> form: (2)Exhibits A-J,any required sections of Exhibit S and Geotechnical Stability Exlul lined in <br /> Rules 6.1,6.2.6.3,6.4.19 and 6.5; and(3)the application fee. When you submit your appli 1)signed and <br /> notarized original and one(1)copy of the application forth,two(2)copies of Exhibits A-J,ap1 _.,ua of 6A.19 Exhibit S and 6.5 <br /> (Geotechnical Stability Exhibit),as required,and a check for the application fee described urxxa(4)below Exhibits should not be bound <br /> or in a 3-ring birder,maps should be folded to 8 1/2"X I I"or 8 1/2"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. ADDlicaut/oaerator or company name(name to be used on the permit): ZyMin Corporation <br /> 1.1 Type of organization(corporation,partnership,etc.): Corporation <br /> 2. Operation name(pit,mine or site name): Ten Percenter Claim (CMC254209) <br /> 3. Permitted acreage(new or existine site): 9.10* permitted acres <br /> 4. Fees: <br /> 4.1 New Application $1,006.00 application fee <br /> 4.2 Amendment Application(from 1.10(2)) <br /> 4.3 Conversion Fee(from 110d to 110(2),(Rule 1.11.2(2)) $1.725.00 conversion fee <br /> 5. Primary commoditie(s)to be mined: Amazonite, Smoky Quartz, Cleavlandite, Columbite/Tantalite <br /> 6. Name of owner to the surface of affected land: Dept. of Agriculture, US Forest Service <br /> 7. Name of owner to the subsurface rights of affected land. ZyMin Corporation via lode mining claim <br /> 8. 7*m of mining operation: a Surface 0 Underground 0 In-situ <br /> * 9.10 Acres is the entire "Affected Area" (Per Exhibit A- Map 4), within which a total of <br /> 4.275 Acres of disturbance is currently planned (Per Exhibit A - Map 5). <br /> Office of office of <br /> Mined Land Reclamafm Denver - Grand junction - Durango Active and Inactive Mines <br />