2021-02-04_PERMIT FILE - M2020057

• Permit No: M2020057
• IBM Index Class Name: Permit File
• Doc Date: 2/4/2021
• Doc Name: Incompleteness Response
• From: Jeff A Carter
• To: DRMS
• Email Name: PSH
• Email Name: JLE
• Media Type: D
• Archive: No

EXHIBIT G-Source of Legal Right to Enter
Rule 6.3.7(Starts on Page 143 of the Rules)
1) Name of owner to the surface of affected land:
Public Domain(BLM) W1 National Forest(USFS)
State State Sovereign Lands
Private (who):
Other(please describe):
2) Name of owner to the subsurface rights of affected land:
Public Domain (BLM) National Forest(USFS)
State State Sovereign Lands
_1 Private (who):
M Other(please describe):
3) If mining is located on Bureau of Land Management Land (BLM) or U.S. Forest Service land (USFS) land
the remaining section must be completed:
i) Claimant: SSG Mining Inc
ii) Serial Number: CMC294753
iii) List Name: Jeff Carter
iv) Address: 15954 Jackson Ck Pkwy B281 Monument CO 80132
v) Telephone: [phone]
vi) Fax Number:
4) If the mining operation is located on private, state, or state sovereign lands, please provide a description of
the basis for legal right of entry to the site and to conduct mining and reclamation for Owners of Record
described in Rule 1.6.2(1)(e)(i). This may be a copy of access lease, deed, abstract of title, or a current tax
receipt. A signed statement by the Landowner(s) and acknowledged by a Notary Public stating that the
Operator/Applicant has legal right to enter and is also acceptable.