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COLORADO CN-1 <br /> 4, Division of Reclamation, <br /> JPUJLE/LJW/THM <br /> a <br /> D N R Mining and Safety <br /> Department of Natural Resources <br /> RECEIVED <br /> REGULAR(112d)DESIGNATED MINING OPERATION <br /> RECLAMATION PERMIT DEC 16 2024 <br /> APPLICATION FORMColorado Division , <br /> Mining and Safety <br /> CHECK ONE: I I New Application(Rule 1.4.5) 111 Amendment Application(Rule 1.10) <br /> I r I Conversion Application(Rule 1.11) <br /> Permit No.M-1 977 -410 (provide for amendments and conversions of existing permits) <br /> The application for a Regular(112d)Designated Mining Operation Reclamation Permit contains three major parts:(1)the application form;(2)Exhibits <br /> A-T,Geotechnical Stability Exhibit,the Emergency Response Plan,and Addendum 1, as required by the Office,and outlined in Rules 6.1,6.2,6.3, <br /> 6.4.19,6.5,8.0,and 1.6.2(1)(b); and,(3)the application fee. When you submit your application,be sure to include one(1)signed and notarized <br /> original and four(4)copies of the application form,five(5)copies of Exhibits A-T,Rule 6.5 Geotechnical Stability Exhibit,the Emergency Response <br /> Plan,Addendum 1,and a check for the appropriate application fee(described under Section(4) on Page 2). Exhibits should not be bound or in a 3-ring <br /> binders; maps should be folded to 8 %Z"X 11"or 8 '/2"X 14"size. To expedite processing,please provide the information in the format and order <br /> described in this form. <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly,in the space provided,all information described below. <br /> 1. Applicant/operator or company name(name to be used on permit): <br /> Grand Island Resources, LLC. <br /> 1.1 Type of organization(corporation,partnership,etc.): Partnership <br /> 1.2 I.R.S.Tax ID No.or Social Security Number: <br /> 2. Operation name(pit,mine or site name): Cross Gold Mine <br /> 3. Permitted acreage:(new or existing site) 9.99 permitted acres <br /> 3.1 Change in acreage(+) 195 ss acres <br /> 3.2 Total acreage in Permit area 205.7 acres <br /> 1313 Sherman Street, Room 215, Denver,Co 80203 P 303.866.3567 F 303.832.8106 ht ps:/lcolorado.Qovldrms *K* : ,_ ;on <br /> Jared S. Polis,Governor I Dan Gibbs, Executive Director I Virginia Brannon, Director , �R i +,/ <br />