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. • RECEIV~ DENVER <br />OCT 24 ~gg4 OFFICE <br />-6- ~ - q~ - ~o~ <br />Description of Amendment: Divigi0n01Minerdlsl~Geology <br />If you are amending or converting an existing operation, provide a brief narrative describing <br />the proposed change(s). <br />Ma a and Hxhibite: <br />Five 5 complete, unbound application packages must be submitted. One complete application <br />package consists of a signed application form and the set of maps and exhibits referenced <br />below as Exhibits A-S and the Geotechnical Stability Hxhibit. Hach exhibit within the <br />application must be presented ae a separate section. Begin each exhibit on a new page. <br />Pages should be numbered consecutively for ease of reference. if separate documents are used <br />ae appendices, please reference these by name in the exhibit. <br />with each of <br />the nape and <br />FsXIiIBIT <br />EXHIBIT <br />EXHIBIT <br />EXEiIBIT <br />HXF[IBIT <br />EXHIBIT <br />fiXH28IT <br />HXHIBIT <br />CilQiIBIT <br />EXHIBIT <br />EXHIBIT <br />HXHIBIT <br />EXHIBIT <br />HXHIBIT <br />EXHIBIT <br />the five (5) signed application forms, you must submit a corresponding set of <br />exhibits as described in the following references to Rule 6.4 and 6.5: <br />A - Legal Description <br />B - Index Map <br />C - Pre-Mining and Mining Plan Map(s) of Affected Lands <br />D - Mining Plan <br />8 - Reclamation Plan <br />F - Reclamation Plan Map <br />G - Water Information <br />H - Wildlife Information <br />I'- Soils Information <br />J - Vegetation Information <br />K - Climate Information <br />L - Reclamation Coete <br />M - Other Permits and Licenses <br />N - Source of Legal Right-To-tinter [See C.R.S. <br />O - Owners of Record of Affected Land (Surface <br />34-32-112 (2)(d)] <br />Area) and Owners of Substance <br />to be Mined [See C.R.S. 34-32-112(2)(b) 6 (c)] <br />fiXFiIBIT P - Municipalities Within Two Miles <br />HXHIBIT Q - Proof of Mailing of Notices to County Commissioners and Soil Conservation <br />District <br />HXEiIBIT R - Proof of Filing with County Clerk and Recorder <br />EXHIBIT S - (any required sections) <br />RIILH 6.5 -Geotechnical Stability Hxhibit <br />The instructions for preparing Hxhibits A-S and Geotechnical Stability Hxhibit are specified <br />under Rule 6.4 and 6.5 of the Mineral Rules and Regulations. If you have any questions on <br />preparing the Hxhibits or content of the information required, or would like to schedule a <br />pre-application meeting you may contact the Office at 303-866-3567. <br />Res onsibilities as a Permittee: <br />Upon app ication approva an permit issuance, this application becomes a legally binding <br />document. Therefore, there are a number of important requirements which you, as a nermittee, <br />should fully understand. These requirements are listed below. Please read and initial each <br />requirement, in the space provided, to acknowledge that you understand your obligations. If <br />you do not understand these obligations then please contact this Office for a full <br />explanation. <br />~QZ~1. Your obligation to reclaim the site is not limited to the amount of the financial <br />warranty. You assume legal liability for all reasonable expenses which the Board or <br />the Office may incur to reclaim the affected lands associated with your mining <br />operation in the event your permit is revoked and financial warranty is forfeited; <br />2. The Board may suspend or revoke this permit, or assess a civil penalty, upon a <br />finding that the permittee violated the terms or conditions of this permit, the Act, <br />the Mineral Rules and Regulations, or that information contained in the application or <br />your permit misrepresent important material facts; <br />~~3. If your mining and reclamation operations affect areas beyond the boundaries of <br />an approved permit boundary, substantial civil penalties, to you as permittee can <br />result; p <br />~~~~~`~ <br />a/~ <br />