2022-06-15_PERMIT FILE - M2022029

• Permit No: M2022029
• IBM Index Class Name: Permit File
• Doc Date: 6/15/2022
• Doc Name Note: check was not endorced to the Division
• Doc Name: Application
• From: Randall K. Kokkinen
• To: DRMS
• Email Name: ERR
• Email Name: JDM
• Email Name: AWA
• Media Type: D
• Archive: No

tsureau or Lana management permits county zoning ana Tana use permits Lity zoning
and land use permits. Disposal of dredge and fill material (404)permits
a. (Optional) If available, please enclose with this application copies of the permits, licenses
and approvals identified above or provide proof of filling.
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:
X Public Domain (BLM)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
Private (who):
Other(please describe): Claim Owner-Randall Kokkinen
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: _Randall K. Kokkinen
ii) Serial Number: _CMC 294343
iii) List Name: _9 to 5
iv)Address: _6751 Golden Sill Court, Castle Pines,CO 80108
v)Telephone: _720-318-8053
vi) Fax Number: N/A
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.
EXHIBIT H-Municipalities within a Two Mile Radius
Rule 6.3.8 (Starts on Page 143 of the Rules)
1) Please list all municipalities (mailing address and telephone of the governing body) located within a
two mile radius of the mine:
Municipality:
Address:
Telephone:
Municipality:
Address:
Telephone:
Municipality:
Address:
Telephone:
Municipality:
Address: