PERMFILE61769

• Permit No: M2006009
• IBM Index Class Name: Permit File
• Doc Date: 1/30/2006
• Doc Name: 112 Reclamation Permit Application
• From: Mesa Sandstone LLC
• To: DMG
• Media Type: D
• Archive: No

-5-
Mans and 8ahibMs:
Two (2) complete, unbound application packages must be submitted. One complete application package consists of a signed applicatian faint
and the set ofmaps and exhibits referenced below as Exhibits A-S, Addendum 1, and the Geotechnical Stability Exhibit. Each exhibiiwithinthc
application must be presented as a separate section. Begin each exhibit on a new page. Pages should be numbered consecutively for ease of
reference. If separate documents are used as appendices, Please reference these by name in the exhibit.
With each of the two (2) signori application forms, you must submit a corresponding set of the maps atxl exhibits asdescribed in the following
references to Rule 6.4, 6.5, and 1.6.2(1 Xb):
EXHBIT A Legal Description
EXHIBIT B Irdex Map
EXHIDIT G Pre-Mixing ark Mining Plan Map(s) of Affected Lands
EXHIBIT D Mining Plan
EXHIBIT E Reclamation Plan
E3CF IIBIT F Reclamation Plan Map
EXHBIT G Water Information
EXHIBIT H Wildlife hifomtation
EXHIBIT I Soils Information
EXHIBIT J Vegetation Information
EXHIBff K Climate Information
EXHIBIT L Reclamation Costs
EXHIBIT M Outer Pemrits and Licenses
EXIIIDIT N Source of Legal Right-To-Enter
EXHIBIT O Owners of Recerd of Affected Land (Surface Area) and Owners of Substance to be Mined
EXHIBIT P Municipalities Within Two Miles
EXHBIT Q Proof of Mailing of Notices to Canty Commissiaoers and Conservation District
EXHIBIT R Proof of Filing with County Clerk or Recorder
EXHIBITS Petmarent Main-Made SWctures
Rule 1.6.2(1 fib) ADDENDUM 1 -Notice Requirements (sample enclosed)
Rule 6.5 Geoterhnical Stabdiry Exhibit (any required sections)
The instructions for preparing Exhibits A-S, Addendum 1, and Geotecttnical Stability Exhibit are specified under Rule 6.4 and 6.5 and
Rule 1.6.2(1 Xb) of the Rules and Regulations. If you have any questions on preparing the Exhibits or content of the information required, or
would like msc~edule apre-application meeting you may contact the Offce at 303-866-3567.
Resnoasibilities as a Permittee:
Upon application approval and permit issuance, this application becor~s a legally binding document. Therefore, there are a
number of important requirements which you, as a permittce, should fully understand. These requiremtents are listod below.
Please read and initial each requirement, in the space provided, to acknowledge that you understand you obligations. Ifyou do rot
understand these obligations them please contact this Office for a full explanation.
• ~ ~ .. 1. Your ob{igation to reclaim the site is not limited to the amount of the financial warranty. You asstune legal
~~~ liability for all reasonable expenses which the Board or the Office may inctu to reclaim the affected lands associated
with yotu mining operation in the event yow permit is revoked and financial warranty is forfeited;
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