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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 C O L O P.A DO <br /> Penner(303)ratio 802 D r V i S t O N o f <br /> FAX:(303)832 8106 M IL N NTCON <br /> LIM, ITF.D 1IMPACT OPERATION(110(2)) SAFETY <br /> RECLAMATION PERMIT <br /> APPLICATION FORM <br /> CHECK ONE: F� New Application(Rule 1.4) M Conversion Application(Rule 1.11) <br /> Permit#M- - (provide for conversions of existing permits) <br /> The application for a Limited Impact Designated Mining Operation Reclamation Permit contains three major parts: (1) the application <br /> form: (2) Exhibits A-J, any required sections of Exhibit S and Geotechnical Stability Exhibit, as required by the Office, and outlined in <br /> Rules 6.1, 6.2,6.3,6.4.19 and 6.5; and(3)the application fee. When you submit your application,be sure to include one(1)sigmed an <br /> notarized original and one(1)copy of the application form,two(2)copies of Exhibits A-J,appropriate sections of 6.4.19 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;traps should be folded to 8 1i2"X I1"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. Applicant/operator or company name(name to be used on the oern-tit): Colorado Calumet Co., Inc. <br /> 1.1 Type of organization(corporation,partnership,etc.): Corporation <br /> 2. Operation name(pit,mine or site name): Detroit City Mine <br /> 3. Permitted acreage(new or existing site): 9.5 permitted acres <br /> 4. Fees: <br /> 4.1 New Application $1,006.00 application fee <br /> 4.2 Amendment Application(from 1.10(21) <br /> 4.3 Conversion Fee(from 11 Od to 110(2),(Rule 1.11.2(2)) $1.725.00 conversion fee <br /> 5. Primary commodities)to be mined: <br /> Mineral specimens <br /> 6. Name of owner to the surface of affected land: Sweet Home Rhodo, I nC. <br /> 7. Name of owner to the subsurface rights of affected land: Sweet Home Rhodo, Inc. <br /> 8. Type of minim operation: Surface 21 Underground 0 In-situ <br /> Office of Office of <br /> Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />