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RECEIVED - 5 - MAR 2 3 2UU1 Mans and ExWbits: Olvlsion of K~iama110n, Mining and Safety Two (2) complete, unbound application packages rtstst be sulmutted. One complete application package consists of a signed application form and the set ofttraps and exhibits referenced below as Exhibits AS, Addetdtan t, artd the Geotechnical Stability Exhibit Each exhibit within the application must be presented u a separate section. Begin each exhibit on a new page. Pages should be numbered consecutively for ease of reference. [f separate docuroenfs are teed as appendices, please refetrrtce these by name k the exhibit With each of the two (2) signed application fours, you must submit a conespondmg set of the maps and exhibits as described is the foltowirtg ceferenccs ro Ruk 6.4, 6.5, and 1.6.2(1 xb): EXHIBIT A Legal Description EXHIBIT B Index Map EXHIBIT C Pte-Mining and Mining Plan Map(s) of Affected Lords EXHIBIT D Mating Plan EXHIBIT E Reclamation Plan EXHIBIT F Reclarrmtion Plan Map EXHIBff G Water hiformation EXHIBTT H Wildlife Information EXHIBIT I Soils Infotmation EXH[BiT l Vegetation Infommtion EXHIBff K Climate Infoirmtion EXHIBIT L Reclamation Costs EXHIBIT M Other Permits abe Licenses C EXHIBIT N Source of Legal Right-TwEnter EXHIBIT O Otvcers of Record of Affected Latd (Surface Area) and Owcers of Substance to be Mined EXHIBff P Municipalities Within Two Miles EXHIBff Q Proof of Mailing of Notices to County Corntrtissiotiera and Conservation District EXHHIfC R Proof of Filing wiW County Cleric or Recorder EXHIBITS Permanent Man-Made Strucnaes Rule 1.tS.2(lxb) ADDENDUM 1 -Notice Requrtetnetits (sample enclosed) Rule 6.5 Geotechoicat Stability Exhibit (sue required sections) The iishuctio~ for preparing Exhibits A-S, Addendum t, and Geotechnical Stability Exiubit are specified order Rule 6.4 aad 6.5 and Rule 1.6.2(1 x6) of the Rates and Regulations. If yon have any gttestiorss on preparing the Exhibits or count of the information required, or would lt7ce to schedule apre-application treating you may contact the Office at 303-&64-3567. Resoons-bilities as a Petmittee: Upon application approval and permit issuance, this application becomes a legally binding document. Therefore, there are a number of important retpiireritents which you, as a petmittee, should fully understand. These requirt:tttentsore listed below. Please read and initial each requiren~nt, in the space provided. to acknowledge that you understand your obligations. Ifyou do not understand these obligations then please wntact this OII'ice for a full explanation. t!`I~ 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 [he Office may incur to reclaim Ilia affected lands associated with your mining operation in the event your permit is revoked and financial warranty is farfeitcd;