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-3- 11. Primary future (Poet-mining) land use (check - one): ropland(CR) C _ Paetureland(PL) _ General Agriculture(GA) g Ran~eland(RL) _ Foreetrx (PR) _ Wildlife Habitat(WL) Residential (RS) _ Recreation (RC) Industrial/Commercial (IC) Developed Water Reeources(WR) _ Solid Waste Disposal (WD) 12. Primary present land use (check one): Cropland(CR) Paetureland(PL) General Agriculture(GA) g Rangeland(RL) _ Forestry(FR) _ Wildlife Habitat(WL) Residential(RS) _ Recreation(RC) _ Industrial/Commercial(IC) _ Developed Water Resources (WR) 13. Method of Mining: _ Quarry (QR) _ Solution (SO) 13.1 Other: Briefly explain mining method (e.g. Placer, truck/shovel). EXCAVATION EQUIPMII~'T AND TRUCKS. 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: _ INJ AA 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 8xhibit. 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 five (5) signed application forme, you must submit a corresponding net of the maps and exhibits as described in the following references to Rule 6.4 and 6.5: EXHIBIT A - Legal Description E]OiIBIT B - Index Map HXHIBIT C - Pre-Mining and Mining Plan Map(s) of Affected Lands EXHIBIT D - Mining Plan EXHIBIT H - Reclamation Plan EXHIBIT F - Reclamation Plan Map EXHIBIT G - Water Information HXHIBIT H - Wildlife Information HXHIBIT I - Soils Information EXHIBIT S - Vegetation Information EXHIBIT R - Climate Information EXHIBIT L - Reclamation Costs EXHIBIT M - Other Permits and Licenses SRHIBIT N - Source of Legal Right-To-tinter (See C.R.S. 34-32-112(2)(d)] EXHIBIT O - Owners of Record of Affected Land (Surface Area) and Owners of Substance to be Mined (See C.R.S. 34-32-112(2)(b) ~ (c)] EXHIBIT P - Municipalities Within Two Miles EXHIBIT Q - Proof of Mailing of Notices to County Commissioners and Soil Conservation District HXHIBIT R - Proof of Filing rith County Clerk and Recorder HXHIBIT S - (any required sections) RIILE 6.5 - Geotechnical Stability 8xhibit The instructions for preparing Hxhibite A-S sad Geotechnical Stability Exhibit are specified under Rule 6.4 and 6.5 of the Mineral Rules and Regulations. If you have any questions on preparing the 8xhibite or content of the information required, or would like to schedule a pre-application meeting you may contact the Office at 303-966-3567.