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r • • III IIIIIIIIIIIII III <br />999 <br />. STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman 51., Raom ? 15 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: 1303)83'_-8706 <br />HARD ROCK/MBTAL MINHS <br />LINITHD IMPACT OPHRATION 110(2)) <br />PHRMIT APPLICATION FORM <br />~.'.. <br />~~I~ <br />DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />Roy Romer <br />Governor <br />lame 5. Lochhead <br />E.ecwive Dveaor <br />Michael B. LOng <br />Division Director <br />CHECK ONE: X New Application (Rule 1.4) <br />Permit # M- - - <br />Conversion Application (Rule 1.11) <br />(provide for Conversions of existing permits) <br />The application for a Limited Impact (110(2)) Mining Operation Reclamation Permit contains three <br />major parts: (1) the application form; (2) Exhibits A-J, Addendum 1, any sections of Exhibit S <br />and Geotechnical Stability Exhibit, as required by the Office, and outlined in Rules 6.1, 6.2, <br />6.3, 6.4.19 and 6.5; and (3) the application fee. When you submit your application, be sure to <br />include one (1) signed and notarized Grev Original and one (1) copy of the application form, two <br />(2) copies of Exhibits A-J, appropriate sections of 6.4.19 (Exhibit S), and 6.5 (Geotechnical <br />Stability Exhibit), as required, and a check for the application fee described under (4) below. <br />Exhibits should NOT be bound or in 3-ring binders; maps should be folded to B 1/2" X 11" or <br />B 1/2" X 14" size. To expedite processing, please provide the information in the format and order <br />described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in tha apace provided, all information described below. <br />---------------------------------------------------------------------------------------------- <br />----- ------------------------------------------------------ <br />1. Applicant/operator or company name (name to be used on permit): <br />Midas Mining Company, Inc. <br />1.1 Type of organization (corporation, partnership, etc.): <br />2 <br />3 <br />4 <br />5 <br />6 <br />1.2 I.R.S. Tax ID No. or Social Security Number: <br />Operation name (pit, mine or site name: <br />Permitted acreage: <br />Feea: <br />4.1 New Application <br />Corporation <br /> <br />Lod <br />9.8~ <br />permitted acres <br />4.2 Conversion Fee (from 110d to 110(2), Rule 1.11.2(2)) <br />Primary commodities to be mined.: Silver Gold <br />Name of owner of the aubeurface riohte of affected land: <br />5875.00 application fee <br />$875.00 application fee <br />Lead Zinc Copper <br />Ophir-Nevada, Inc. <br />Ophir-Nevada, Inc. <br />7. Name of owner of the surface of affected land: <br />a. Names of the holders of any recorded easements on the affected land: <br />None <br />8. Type of mining operation: Surface X Underground In-situ <br />