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~ ~ IIIIIIIIIIIIIIIIIII <br />LIMITED IMPACT OPERATION (110(2)) ~,~f~ <br />APPLICATION FOR14 `` ' ~~ ~ `-' :3 -~ <br />The Application for a Limited Impact Operation Reclamation Permit contains ttih8~e~in~ajor°U <br />parts: (1) the Application Form, (2) the Application Exhibits A-F, and (~)Nt ~~tvv <br />application fee. When you submit your Application, be sure to include~e~ ~}~~ ~,^~J <br />of the Application Form, two copies of Exhibits A-F, and a check for the app rca on 'fee <br />described under (4) below. To expedite processing, please provide the information in <br />the format and order described in this form. <br />_______________________________________________~! 9~ ~? __ ~ ~~5i?== ~-X15-°~===_____- <br />GENERAL OPERATION INFORMATION RQC~J . lalo93 <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/Operator Name: <br />Leadville Mining ~ Milling Corp. <br />2. Operation Name (Pit, mine or site name): <br />Mi1nel - Leaav~l~eSCustom Mill <br />3. Application type: Limited Impact Operation (110). <br />4. Application Fee for Permitted Acreage* g,5 permitted acres. <br /> (S10 x (affected acres) + ;25.00).* <br /> Note permitted acreage and application fee and <br /> attach a check for this amount when you file. $115.00 application fee. <br />5. Substance(s) to be mined (e.g., gold/silver/gravel): gold, silver, lead, zinc. <br /> copper , iron <br />6, Owners (s) of Substance to be Mined <br /> (check applicable box(s)): x Private _ State _ Federal _ Indian <br />7, Owner(s) of Record of Affected Land <br /> (check applicable box(s)): X Private State Federal Indian <br />8, Type of Mining Operation <br /> (check applicable box(s)): _ Surface X Underground _ In-situ <br />9, Location Information. The center of the area where the majority of mining will <br /> occur lies in: MINE <br />COUNTY: Lake <br />PRINCIPLE ERI IAN c ec one xx 6th (Colorado) 10th (New Mexico) Ute <br />TOWNSHIP (write number and check direction): T 9 North X South <br />RANGE (write number and check direction): R 79 _ <br />East X West <br />SECTION (write number): S 20 _ <br />_ <br />QUARTER SECTION (check one): Nom- NW x SE SW <br />QUARTER/QUARTER SECTION (check one): _ <br />NE _ <br />_ <br />NW x <br />SE SW <br />GENERAL DESCRIPTION: _ _ <br />_ <br />_ <br />(miles dnd direction 3.3 miles east from 5th St. b. Harrison <br />from nearest town and <br />approximate elevation) ave., Leadville, co. Elevation: 10,560 Ft. <br />* If the operator is a unit of State or county government, an application fee is not <br />required, A fraction of an acre must be counted as one acre for fee calculation. <br />