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REGULAR OPERATION (112) RECLAMATION PERMIT APPLICATION FORM ~ The application for a Regular Operation Reclamation Permit contains three major parts: Cl> the appiication form; (2) Exhibits A-S; and, (3) the application fee. When you subm it your application, be sure to Include five (5) signed copies of the application form five (5) copies of Exhibits A-S, and a check for the application fee described unde r Section (14) on Page 3. To expedite processing, please provide the Information In the format and order described In this form. GENERAL OPERATION INFORMATION Type or print cieariy, in the space provided, all information described below. 1. Applicant/Operator name: SAND CREEK FARMS. INC. • 1.1 iype of organization (corporation, partnership, etc.>: Corporation 2. Operation name (pit, mine or site name): SAND CREEK MINE 2.1 I.R.S. Tax ID No. or Social Security No.: Tax ID No. 4 • 3. Permitted Acres: 40 Permitted acres Please indicate acreage to the nearest tenth (10th) acre. 3.1 Application fee (see Section 14): $1,875.00 Application Fee 4. Substance(s) to be mined (e.g., gravel/gold/borrow): SAND ~ 5. Name of owner of surface of affected land: Sand Creek Farms, Inc. 6. Name of owner of subsurface rights of affected land: Sand Creek Farms, inc. If 2 or more owners, refer to Exhibit P. 7. Type of mining operation: R Surface _ Underground • 8. Location Information: the center of the area where the majority of mining will occur lies in: COUNTY: ADAMS ~ PRINCIPAL MERIDIAN (check one): x 6th (Colorado) _ ]0th (New Mexico) Ute TOWNSHIP (write number and check direction): T 3 _ North X South ' RANGE (write number and check direction): R 61 _ East X West SECTION (write number): S 3 - South Half QUARTER SECTION (check one): NE NW SE SW QUARTER/QUARTER SECTION (check one): _ NE _ NW _ SE _ SW • GENERAL DESCRIPTION: (miles and direction Approximately 7 1/2 miles north of Hvers from nearest town and Colorado. Approximate elevation = 5,400. approximate elevation) • •