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-~/ <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND <br />Department of Natural Resources <br />1313 Sherman 51., Roam 215 <br />Denver, Colorado 80203 <br />Phone: (303) 8663567 <br />FAX: 1303) 8328106 <br />_ _ , p. - i <br />AUG C ~. 2005 <br />Divisior ^' I' ~~ ~ •~+~ 1= ~ &e6169V <br />REGULAR (112d) DS3ZGNATED MINING OPERATION <br />COLORADO <br />D I v 15 1 0 N O F <br />MIN &RALS <br />GEOLOGY <br />iECLatl•}~ON•MINING <br />SA FE TY•EC iE NCE <br />RECEIVED/ Bill Owens <br />RECLAMATION PERMIT Governor <br />200C APPLICATION FORM Russell George <br />AUG 0 5 J Eaecuiive Director <br />Ronald W. Cattany <br />Division DIrKIOr <br />Division ~i Minerals and Geology Natural Resourm Trustee <br />CHECK ONE: New Application (Rule 1.4.5) ~ Amendment Application (Rule 1.10) <br />_ Conversion Application (Rule 1.11) <br />Permit No. M- /977 - 4 9 3~ (provide for amendments and conversions of <br />existing permits) <br />The application for a Regular (112d) Designated Mining Operation Reclamation Permit <br />contains three major parts: (1) the application form; (2) Exhibits A-T, Geotechnical <br />Stability Exhibit, the Emergency Response Plan, and Addendum 1, as required by the <br />Office, and outlined in Aules 6.1, 6.2, 6.3, 6.4.19, 6.5, 8.0, and 1.6.Z(1)(b); and, (31 <br />the application fee. When you submit your application, be sure to include one (1) si ned <br />and notarized Gray original and four (4) copies of the application form, five (5) copies <br />of Exhibits A-T, Rule 6.5 Geotechnical Stability Exhibit, the Emergency Response Plan, <br />Addendum 1, and a check for the appropriate application fee (described under Section (4) <br />on Page 2). Exhibits should not be bound or in a 3-ring binders; maps should be folded to <br />B '•4" X 11" or 9 ~" X 14" size. To expedite processing, please provide the information in <br />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 /> <br />1. Applicant/operator or company name (name to be used on permit): <br />~~+MAK MGIi/B()ENGiM (°c~,~•1 VA,yy ~ (~/iMAN M/N~ <br />1.1 Type of organization (corporation, partnership, etc.): C ~RPORlLYioA1 <br />1.2 I.R.S. Tax ID No. or Social Security Number: I~'(r, P~"Sd yd <br />2. Operation name (pit, mine or site name) : C I iMAY MfNE <br />3. Permitted acreage: (new or existing site) _ y S~LO, g permitted acres <br />3.1 Change in acreage (+) ^/p CARN(riE acres <br />3.2 Total acreage in Permit area ~ s L0+0 acres <br />Office of OHrce of Colorado <br />Mined Land Reclamation Active and Inactive Mines Geological Survey <br />