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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 /> Demrer,Colorado$0203 D COLOR-ADO <br /> E <br /> � �/� DIVISION O f <br /> phone: 1 M e" RECLAMATION <br /> FAX:t � MINING <br /> JUN 0 2023 <br /> DESIGNATED MINING <br /> SAFETY <br /> � r LIMITED IMPACT(110d)OPERATION <br /> �wtadoDi` Y RECLAMATION PERMIT APPLICATION FORM <br /> Mtnln9 <br /> ERR/MAC <br /> CHECK ONE: New Application(Rule).a) C Amendment Application(Rule 1.8 or 1.10) <br /> Conversion Application(Rule 1.)i) <br /> Permit!#M-2=-015. (provide for Amendments and Conversions of existing permits) <br /> The application for a Limited Impact(110d)Designated Mining Operation Reclamation Permit contains three major parts: (1)the application <br /> form;(2)Exhibits A-J,Exhibit L,Exhibit T,the Geotechnical Stability Exhibit,the Emergency Response Plan,and Addendum 1,as required by <br /> the Office,and outlined in Rules 6.1,6.2,6.3,6.4.20 6.5,8,and 1.6.2(1)(b);and(3)the application fee. When you submit your application,be sure <br /> to include one(1)signed and notarized Original and one(1)copy of the application form,two(2)copies of Exhibits A-J,Exhibit L,Exhibit T,the <br /> Geotechnical Stability Exhibit(Rule 6.5),the Emergency Response Plan(Rule 8),and Addendum 1(Rule 1.6.2(1)(b)),as required,and a check for <br /> the application fee described under(4)below. Exhibits should NOT be bound or in 3-ring binders;maps should be folded to 8 2"X 11"or 8 2"X <br /> 14"size. To expedite processing,please provide the information 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. Applicantloperator or company name(name to be used on permit): MineWater LLC <br /> 1.1 Type of organization(corporation,partnership,etc.): LLC <br /> 1.2 I.R.S.Tax ID No.or Social Security Number: <br /> 2. Operation name(pit,mine or site name): London Mine <br /> 3. Permitted acreage(new or existine site): 9.9 permitted acres <br /> � <br /> 3.1 Change in acreage(+) 0. acres <br /> Total Acreage in Permit Area 9.9 acres <br /> 4. Fees: (Rule 1.5) <br /> 4.1 New Application $2175.00 application fee <br /> 4.2 Amendment Fee(operations existing as of 06/30/94) $1,725.00 application fee <br /> 4.3 Amendment Fee(operations permitted from 07/01/94) $2.300.00 application fee <br /> 4.4 After July 1,1995,to convert a 110(1),110(2)or a 110 to a t 10(d),a new application form fora i l0d must be submitted,along <br /> with an application fee of S2,875.00(Rule 1.11.2(2)). <br /> 5. Primary commodities to be mined: Gold and Silver n <br /> 6. Type of minine operation: Surface El Underground .JI In-situ <br /> Office of Office of <br /> Mined land Reclamation Denver • Grand)unction • Duraw Active and Inactive Mines <br />