2006-09-21_REVISION - M1980149

• Permit No: M1980149
• IBM Index Class Name: Revision
• Doc Date: 9/21/2006
• Doc Name: 112c application
• From: Weld County
• To: DRMS
• Type & Sequence: AM3
• Media Type: D
• Archive: No

-5-
iVlaos and Exhibits:
Two (2) complete, unbound application packages must be submitted. Oae complete application package consists ofa signed application
form and the set of maps and exhibits referenced below as kxhibits A-S, Addendum 1, and the Geotechnical Stability Exhibit. Each exhibit
within the 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) signed application forms, you must submit a corresponding set of the maps and exhibits as described in [he
following references to Rule 6.4, 6.5, and 1.6.2(1)(b):
EXHIBIT A
EXHIBff B
EXHIBIT C
EXHIBIT D
EXHHiTT E
EXH[Bff F
EXHIBIT G
EXHIBIT H
EXHIBIT I
F,XHIAIT J
EXHHBIT K
EXIHBIT h
EXIIIBIT M
EXHIBIT N
EXHIBIT O
EXHIBIT P
EXHIBIT Q
EXHIBIT R
EXIIIBIT S
Rule 1.6.2(])(b)
Rule 6.5
Legal Description
Index Mep
Pre-Mining and Mining Plan Map(s) of Affected Lands
Mining Pian
Reclamation Ptan
Reclamation Plan Map
Water Infomration
Wildlife Infomration
Soils Information
Vegetation Information
Climate Information
Reclamation Costs

5EP 2 8 't006
Division of K8r:18tltatlOD,
Mining art<3 Sefeb
Other Permits and Licenses
Source of Legal Right-To-Enter
Owners of Record of Affected Land (Surface Area) and Owners of Substance to be Mined
Municipalities Within Two Miles
Proof of Mailing of Notices to County Commissioners and Conservation District
Proof of Filing with County Clerk or Recorder
Permanent Man-Made Structures
ADDENDUM 1 -Notice Requirements (sample enclosed)
Geotechnical Stability Exhibit (any required sections)
"The instructions for preparing Exhibits A-S, Addendum 1, and Geotechnical Stability Exhibit are specified under Rule G.4 and 6.5 and
Rule 1.6,2(1)(b) of the Rules and Regulations. [f you have any questions on preparing the Exhibits or content ofthe information required,
or would like to schedule apre-application meeting you may contact the Office at 303-866-3567.
Responsibilities as a Permittee:
Upon application approval and permit issuance, this application becomes a legally binding document. 'Pherefore, there are a
number of important requirements which you, as a permittee, should fully understand. These requirements are listed below.
Please read and initial each reyuirement, in the space provided, to aclmowledge that you understand your obligations. ]fyou do
~rstand these obligations then please contact this Oilice for a full explanation.
1. 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 permit is revoked and financial warranty is forfeited;