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STATE OF COLUI�Jwu <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Depamnent of Natural Resources C O L O R A D O <br /> 1313 Sherman St-,Room 215 <br /> DIVISION <br /> EC tLAMATION <br /> Denver,colaado 80203 MINING <br /> Phone:(3031866.3567 <br /> FAX:(3031832-5106 SAFETY <br /> DESIGNATED MINING — �— <br /> LIMITED IMPACT(110d)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM <br /> CHECK ONE: New Application(Rule 1.4) a Amendment Application(Rule 1.8 or 1.10) <br /> Conversion Application(Rule I.t t) <br /> Permit#M- TSW-OU-_ (provide for Amendments and Conversions of existing permits) <br /> The application for a Limited Impact(1 I Oil)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(I)(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 torn,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 I I"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. Applicant/operator or company name(name to be used on permit): Union Milling Company <br /> 1.1 Type of organization(corporation,partnership,etc.): LLC <br /> 1.2 I.R.S.Tax ID No.or Social Security Number: 46-1790072 <br /> 2. Operation name(pit mine or site name): Leadville Mill <br /> 3. Permitted acreage(new or existing site): 9.9 permitted acres <br /> 3.1 Change in acreage(+) -1 .6 acres <br /> Total Acreage in Permit Area 8.3 acres <br /> 4. Fees: (Rule 1.5) <br /> 4.1 New Application $2,975.00 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) $2300.00 application fee <br /> 4.4 After July 1,1995,to convert a 110(1),110(2)ors.110 to a 110(d),a new application form for a 1 l Od must be submitted,along <br /> with an application fee of$2,975.00(Rule 1.11.2(2)). <br /> 5. Primary commodities to be mined: Gold, Silver <br /> 6. Type of mining operation: E Surface Q Underground L In-situ <br /> Office of Office of <br /> Mined Land Reclamation Denver " Grand Junction " Durango Active and Inactive Mina <br />