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1 -3- ' 11. Primary future (Poet-mining) land use (check one): CropTand(CR) Paetureland(PL) General Agriculture(GA) _ Ranyeland(RL) _ Forestrx(FA) ~ Wildlife Habitat (WL) Residential(RS) _ Recreation(RC) Industrial /Commercial(IC) ' _ Developed Water Resources (WR) _ Solid Waste Disposal (WD) 12. Primazy present land use (check one): _ Cropland{CR) _ Pastureland(PL) General Agri culturelGA) ' = Ranyeland(RL) _ Forestrx (FR) -_X Wildlife Habitat (WL) Residential(RS) Recreation(RC) Industrial/Commercial(IC) Developed Water Resources(WR) 13. Method of Minims: ~ Quarry (QR) _ Solution (SO) ' 13.1 Other: Briefly explain mining method (e.g. Placer, truck/shovel). TOD Down Excavation Method - Drv Alluvial Operation ' 14. On Site Processing: = Solution (SO) =Chemical (CH) _ Thermal (TH) Heap Leach (HL) Vat Leach (VL) List any designated chemicals or acid-producing materials to be used or stored within permit area: None Description of Amendment: If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s). Ma s and Exhibits: Five 5 complete, unbound application packages must be submitted. One complete application package consists of a signed application form and the set of maps and exhibits referenced below as exhibits A-S and the Geotechnical Stability Exhibit. Hach exhibit within the application IItust be presented as a sepazate section. Begin eac1~ exhibit on a ' sew page. Pages should be numbered consecutively for ease of reference. If sepazate documents are used as appendices, please reference these by name in the exhibit. With each of the five (5) signed application forms, you must submit a corresponding set of the maps and exhibits as described in the following references to Rule 6.4 sad 6.5: ' fi%FiIBIT A - Legal Description EffiiIBIT B - Index Map &XFiIBIT C - Pre-Mining and Mining Plan Map(s) of Affected Lands ESfiiIBIT D - Mining Plan EffiiIBIT & - Reclamation Plan EffiiIBIT F - Reclamation Plan Map fiXHIBIT G - Water Information ' fiXHIBIT H - Wildlife Information fiXHIBIT I - Soils Information EXHIBIT J - Vegetation Information EXHIBIT R - Climate Information ' fiEtiIBIT L - Reclamation Costs ESFIIBIT M - Other Permits and Licenses fiffiiIBIT N - Source of Legal Right-TO-Hater [See C.R.S. 34-32-112(2)(d)] ESIiiIBIT O"- Owners of Record of Affected Land (Surface Area) and Owners of Substance ' to be Mined ISee C.R.S. 34-32-112(2)(b) 6 (c)) . EffiiIBIT P - Municipalities Within Two Miles fi%HIBIT Q - Proof of Mailing of Notices to County Commissioners and Soil ' - Conservation District EXHIBIT R - Proof of Filing with County Clerk and Recorder fi~iIBTT S - (any required sections) RIILE 6.5 - Geotechnical Stability Exhibit ' The instructions for preparing Exhibits A-S and Geotechnical Stability Exhibit are specified wader Rule 6.4 and 6.5 of the Mineral Rules and Regulations. If you have any questions on preparing the Exhibits or content of the information required, or would like to schedule a pre-application meeting you may contact the Office at 303-.866-3567.