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' RECEIVED <br /> COLORADO APR 142021 <br /> Division of Rectatnatia;t D'WSIONOF <br /> Mining and Safety MININGANp �E..��+V <br /> L)MI i LO IMPACT()P£RATION 11 1 <br /> �! t1 <br /> RECLAMATION PERMIT <br /> kPPLICAMN FORM <br /> S tiLU Q-A rv� Na%& +lppla wil <br /> Prnrtt F 41 __ ipsmade Cur comea-sawm and araendrocrits of extsung petmttai <br /> f hr app{tcxti.xt taaf a t tmtuc.t Etttp�t !I(k 1+ Mining Operatim RaclarnrRt<m Parisi contatans threr mm)or part►, I l i altc a1►paa miitxuro fium. <br /> 121 E xhit±ac.A.J.our m4uvW*mtxxu of Exhibit S wW(natAct.•Iwtxat Stabtlit)E:a htlm its requuv i b3 the t nCux,and"lined to Rule%h 1, <br /> b n e at.d n�. 1•i thr ap(*la.atMxt fee Whn vtw aaabaat ycxa apphrat be sta!c w tnc)taalc aloe t►► 1121i1L1Lt3�oasg�aal <br /> atsd.+rsr t I t�uupy vi tttr a{ap+a.atacxa laariaa,tr.rr i�i Cat;MCb oCFxhtlsttt:A-!,aax16.5 t(icuacr.-limrsl'Sta�sftty ExbsMAt.r rrgtatrexl,arc!t��a.k <br /> kw the appia:rt*tw Iee 4ewnbed twofer I;I tv" FxteatwN should RK be bound or in a 1-rngq binder. reaps shioul!bo Folded to x 1 a" X <br /> I I" .x ti 1 !-X 14-.Arc Jo vkpLNl ac prmxm sng.pleast pttr.xk the a forrastwn to the format and order dt.cnbtd in this kirm <br /> GE'NLRALOPERATWN'1NFtiWUATION <br /> Type or prist cltarh.is tbt space paw►ided,sN atfirm*tioa described bel" <br /> i 1 i1H3fitRitLer>�cosuaas K�to is be rtiarQ as tits k Jeff A Carter <br /> I I I ype tit exVitfuzatkon tcorVotation.psrtteeship.ew i I� <br /> Qnmdm ease(nit.-"-or am aa=i: Lomb#rd#3 <br /> ? (nusaa be 5 aura w itw 2 prnmucS&.Cc% <br /> 4 fAm <br /> At NvA ApEs waution ! applicatxrt tic <br /> 5 prknsry c+waw djtWs)to be of mA, Gold as SINCr <br /> h swat of owner to rbe surface of afEteand hud. US F rest Service <br /> IT Name of owner to for mibsnrface r*W of affcataati kwd US FOMSt SeMCe_ <br /> K Ttpe of wiWag operatlos: fi larfact Undcrgtound 11Plaaa er <br /> ,.a <br /> 1111 Stwirmin 5trert,Soom YrS,Deaver.CO 8=3 P X1AU&.1567 f 301.t.1 4XW Itttp:i traairarry itato.co..rt <br />