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,8m-~~ <br />DIVISION OF MINERALS AND GEOLOGY <br />CONSTRUCTION MATERIALS <br />Regular (112) Mining Operation <br />Application Worksheet/Checklist / <br />New App: Amendment App: / Conversion App: <br />/ t/ <br />Operator: Adams County RV Park, LLC dba 129b° Estates Partners Permit: M-2001-085 <br />Mine Name: 124th Estates Sand and Gravel Mine / Rec Date: 09/17/2002`/ <br />APPLICATION FORM (Rule 1.6.2 and 1.6.3): operator nay is incorrect line 1 Page 1, and <br />Page 3 and on the Signature page. Notarization of Signature page is incomplete. The Operators <br />name moat be corrected throughout the entire application package or the Operator moat do a <br />Succession of Operators application. 10/08/2002 Operator Name corrected <br />ITEMS <br />COMPLETED 1 2 3 4 5 6 <br /> / / / / / <br />ITEMS <br />COMPLETED 7 8 9 10 11 12 <br /> / / / / / / <br /> 15 <br />ITEMS 13 14 CONV/AMEND PERMZTEE SIG <br />COMPLETED DESCRIPTION RESP completed <br /> 10/08/2002 <br /> / / / / <br />MAPS and EXHIBITS (Rule 6.2) <br />ADEQUACY COMMENTS <br />EXHIBIT A - 6.4.1 - LEGAL DESCRIPTION: / <br />