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<br />~~~ ~~~~~~~I~~~~~~~~ ~ RECEI~/E® <br />JUN 2 2 2001 <br />LIMITED IMPACT OPERATION (110(2)) <br />RECLAMATION PERlffT Division of Minerals and Geology <br />APPLICATION FORM <br />CHECK ONE: X New Application (Rule 1.4) _ Amendment Application (C.R.S. 39-32.5-110) <br />Conversion Application (Rule 1.11) <br />Permit # M- - (provide for amendments and conversions of <br />existing permits) <br />iM-ZoOi~ Olo3 <br />The application fora Limited Impact Mining Operation Reclamation Permit contains three major <br />parts: (1) the application form; (2) fixhibits A-J, Addendum i, any sections of Exhibit S and <br />Geoterhnical Stability~Exhibit, as required by the Office, and outlined in Rules 6.1, 6.2, <br />6.3, 6.4.19 and 6.5; and (3) the application fee. When you submit your application, be sure <br />to include one (1) sinned and notarized original and one (1),copy of the application form, <br />two (2) copies of Exhibits A-J, appropriate sections of 6.4.19 Exhibit S and 6.5 <br />(Geotechnical Stability Exhibit), as required, and a check for the application fee described <br />under (4) below. Exhibits should not be bound or in a 3-ring binder; maps should be folded <br />to 8 1/2" X 11^ or 8 1/2" X 14^ size. To expedite processing, please provide the information <br />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 />i Applicant/operator or company name (name to be used on permit): <br />1.1 Type of organization (corporation, partnership, etc.)• CO oratl0ri <br />1.2 I.R.S. Tax ID No. or Social Security Number: <br />2. Operation name (pit, mine or site name): Ophir Lode <br />3. Permitted acreage (new or existing site): 9.8~ permitted acres <br />3.1 Change in acreage (+ or -) acres <br />Total Acreage in Permit Area 9• acres <br />4. Fees: <br />4.1 New Application 5875.00 application fee <br />Amendment Fee (C.A.S. 34-32.5-125(II)) 5575.00 application fee <br />4.2 Conversion Fee (from 110d to 110 E7S 5.00 conversion fee (Rule 1.11.2(2)) <br />s. Primary commoditie(s) to be mined: Silver Gold Lead Zinc Copper <br />6. Name of owner of the subsurface rights of affected land: Ophir-Nevada, InC. <br />7. Name of owner of the surface of affected land: Ophir-Nevada, InC. <br />8. Type of mining operation: Surface X IInderground In-situ <br />9. Location information. The ten er of the area where the majority of mining will <br />occur lies in: Hinsdale <br />CODNTY: <br />PRINCIPAL MERIDIAN (check one): 6th (Colorado) 10th (New Mexico) IIte <br />SECTION (write number): S 20 <br />TOWNSHIP (write number and check direction): T X North South <br />RANGE (write number and check direction): R East X west <br />QUARTER SECTION (check one): NE ]L_ NW SE SW <br />QUARTER/QUARTER SECTION (check one): NE X NW SE Sw <br />GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and <br />the approximate elevation) Capitol Clty 11,200 feet <br />elevation at mine adit <br />