PERMFILE57762

• Permit No: M2001060
• IBM Index Class Name: Permit File
• Doc Date: 6/26/2001
• Doc Name: PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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Maps & E:hibits:
Submit two (2) complete, unbound copies of the following application exhibits:

6.3.1 EXHIBIT A -Legal Description and Location Map
6.3.2 EXHIBIT B -Site Description
6.3.3 EXHIBIT C -Mining Plan
6.3.4 EXHIBIT D -Reclamation Plan
6.3.5 EXHIBIT E -Maps, to include the location of any recorded easemenu
6.3.6 EXHIBIT F -List of Other Permits and Licenses Required
6.3.7 EXHIBIT G -Source of Legal Right-to-Enter, to include holders of any recorded easements
6.3.8 EXHIBIT H -Municipalities Within a Two-mile Radius
6.3.9 EXHBIT 1- Proof of Filing with County Clerk
6.3.10 EXHBIT J - Proof of Mailing Notices of Permit Application
6.3.12 EXHIBIT L -Permanent Man-Made Structures
1.6.2(1)(b) ADDENDUM 1 -Notice Requirements (sample enclosed)
6.5 Geotechnical Stability Exhibit (as required)
Responsib0ities as a Permittee:
Upon application approval and permit issuance, this application becomes a legally binding document. Therefore, there are a number of
important requiremratts which you, as a permittee, should fully understand. These requirements are listed below. Please read and initial
each reouirement, in the space provided, to aclmowledge that you understand your obligations. If you do not understand these obligations
th/en~please contact this Office for a full explanation.
`~' l . Your obligation to reclaim the site is not limited to the amount of the financial warranty. You assume legal liability for
all reasonable expenses which the Board or the Office may incur to reclaim the affected lands associated with your mining
operation in the event your pemtit is revoked and financial warranty is forfeited;
2. The Board may suspend or revoke this permit, or assess a civil penalty, upon a finding that the permittce violated the
tetras or conditions of this permit, the Act, the Mineral Rules and Regulations, or that information contained in the application
/ ~q or your permit misrepresent important material facts;
~ 3. L`your mining and reclamation operations affect areas beyond the boundaries of an approved permit boundary, substantial
// .~~--,, civil penalties, to you as petmittee can result;
!~J 4. Any modification to the approved mining and reclamation plan from those described in your approved application requires
//+~ you to submit a permit modification and obtain approval from the Board or Office;
/~~`~ 5. It is your responsibility to notify the Office of any changes in your address or phone number;
,~ 6. Upon permit issuance and prior to beginning on-site mining activity, you must post a sign at the entrance of the mine site,
which shall be clearly visible from the access road, with the following information (Rule 3.1.12):
a. the name of the operator;
b. a statement that a reclamation permit for the operation has been issued by the Colorado Mined Land Reclamation
Board; and,
c. the permit number.