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DNR COLORADO RECEIVED <br /> CO j Division of Reclamation, <br /> Mining and Safety JUN 11 2025 <br /> Department of Natural Resources <br /> 1313 Sherman Street, Room 215 Colorado Division of Reclamation, <br /> Denver, CO 80203 Mining and Saftey <br /> LIMITED IMPACT OPERATION(110(1)) <br /> RECLAMATION PERMIT M-2025-030 <br /> APPLICATION FORM E R R/ZTT <br /> CHECK ONE: EL New Application <br /> Permit#M- (provide for conversions and amendments of existing permits) <br /> The application for a Limited Impact 110(1) Mining Operation Reclamation Permit contains three major parts: (1)the application form; <br /> (2)Exhibits A-J,any required sections of Exhibit S and Geotechnical Stability Exhibit,as required by the Office,and outlined in Rules 6.1, <br /> 6.2,6.3,and 6.5;and(3)the application fee. When you submit your application,be sure to include one(1)signed and notarized original <br /> and one(1)copy of the application form,two(2)copies of Exhibits A-J,and 6.5(Geotechnical Stability Exhibit),as required,and a check <br /> for the application fee described under(4)below. Exhibits should not be bound or in a 3-ring binder;maps should be folded to 8 1/2"X <br /> 11"or 8 1/2"X 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. Applicant/operator or company name(name to be used on the permit): MILE HI ROCK AND MINERAL SOCIETY <br /> 1.1 Type of organization(corporation,partnership,etc.): Non Profit <br /> 2. Operation name(pit,mine or site name): RAMS HOME <br /> 3. Permitted acreage(new or existing): (must be 5 acres or less) 5 permitted acres <br /> 4. Fees: <br /> 4.1 New Application S288.00 application fee <br /> 5. Primary commoditie(s)to be mined: AMAZONITE,SMOKEYQUARTZ,CLEAR QUARTZ, FELSPAR <br /> 6. Name of owner to the surface of affected land: Forest Service <br /> 7. Name of owner to the subsurface rights of affected land: Forest Service <br /> 8. Type of mining operation: 1 Surface ri Underground n Load <br /> OF COO <br /> • <br /> ( 0. <br /> h t- i O <br /> 1313 Sherman Street, Room 215, Denver, CO 80203 P 303.866.3567 F 303.832.8106 http://mining.state.co.us * ' ) ', */ <br /> */a76* <br />