2020-09-01_PERMIT FILE - M2019007

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A7COLORADO Division of Reclamation, Mining and Safety 1313 Sherman Street, Room 215 Denver, CO 80203 LIMITED IMPACT OPERATION(110(1)) RECLAMATION PERMIT APPLICATION FORM CHECK ONE: Fv], New Application Conversion Application(Rule 1.11) Permit#M-2019 -007 (provide for conversions of existing permits) The application for a Limited Impact 110(l) Mining Operation Reclamation Permit contains three major parts: (1)the application form; (2) Exhibits A-J, any required sections of Exhibit S and Geotechnical Stability Exhibit, as required by the Office, and outlined in Rules 6.1, 6.2, 6.3, and 6.5; and(3) the application fee. When you submit your application,be sure to include one (1) signed and notarized original and one(1)copy of the application form,two(2)copies of Exhibits A-J,and 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 8 1/2"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. AAppGcant/operator or company name(name to be used on the permit): Asteroid Explorations LLC 1.1 Type of organization(corporation,partnership,etc.): LLC Corp 2. Operation name(pit,mine or site name): Kichelmann One 3. Permitted acreage(must be 5 acres or less): 3 permitted acres 4. Fees- 4.1 New Application $288.00 application fee 4.2 Amendment Application .J 66$ 1.00 amendment fee 4.3 Conversion Fee(from 110(2)to 110(1),(Rule 1.11.2(2)) $288.00 conversion fee 5. Primary commodities)to be mined: Gold 6. Name of owner to the surface of affected land: Sally Kichelmann 7. Name of owner to the subsurface rights of affected land: Sally Kiechelmann 8. Type of mining operation: ]Surface F1 Underground Placer i