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ACT-~~-1954 12~F15 FP.O~•t CSI-104TH TO 9891655 P.02 • • - -6- Dgaeri tion of Am ailment: If Vou are amen Lag or converting an exiwr-ing txllaratign, provide a brief narrative dna:cribiag the proposed chaage(s1. ale v and L=xh.ibi Five 5 camp ete,~unbound application packages must be submitted. One complete application paeYage consists of g signed application form and the set of maps and exhihira referenced below as 8xhibits A-s and the Geotechaical Stability 8xhibit. Hach exhibit within the application must be presented as a separate section. Begin each exhibit oa a new page. pages s:auuld try iwud~czcd coaaecutivaly 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 forms, you must submit a corresponding set of the maps and exhibits ae described is the folloaing references to Rule 6.4 and 6.5: Sxtiiblr A - Legal Description S7Ci26TT 6 - Index Map SX5tIB2T C - P.e-Miuiuy nail Mining elan Map(s) of Affected Lands BXFSIBTT D - S4iaiag Plan BYiii82T t - Roalamatioo Plaza EXHIBIT P - Reclamation Plan PSap EY3SIHIT G - Water Tnfnrmatinn S7DiIBIT H - Wildlife Information 8)QiIBIT I'- Soils Information EXHIBIT J - vegetation Information SXHIBST K - Climate Infortation S~BTT L - Reclamacioa Costs EIIiIBIT !S - Other Fermata and Licensee ~SZSIT x - Source of legal Right-TO-Beater !See C.R.S. ESHIBZT 0 - Owners of Record of Affected Land (Surface to be aSlned [See C.k.S. 34-3L-11212)(b) fi SIT p - Muaieipalities Within Tao Miles 34-32-112(2)(d)I Area) and Owners of Substance cc)) E86ISZT Q - eroaf of !Sailing of xvtices to Cuuaty Crvmuissiaaera and Soil CoIlSeriratioa Diatr=ct EY8r8ZT F - rroo£ of Piling with County Clerk aucl ReGLi ilea 870iI82T S - (any required sections) RIIf.B 6.5 - Aantechnical Stability Exhibit The iastructi~s for prepari.na Ext'.ibits A•S and Geotecbnical Stability Exhibit are specified undo= Rule 5.4 a,aCl 5.5 Vf the Mineral Ra1ee and KegUldt].OAS. IL you have nay gl3e6LlOria On preparing t'Se exhibits oz content cf the information required, or would like to schedule a prp-a~7ication meeting you may contact tho Of£icc at 303 866~35G7. R~ oaeibili i ac t~ Peti•.l.iL Upon appiacatLOra approv as permit issuance, this application becomes a legally binding document. Therefore, there are a number o£ impnrtant requirements which you, ae a permitece, s:iwld fully understand. These requiremeate are listed below. Please read and .initial each requirement, is the space provided, to acknowledge that you ~mderstand Your obligations. If you eo not understand these obligations then please contact this Office for a full explanation. 1. Your obligatica to reclaim the site is not limited eo the amount of the financial warranty. You assume legal liability for all reasonable eaq~enses which the Board or [he VSfice may incur to reclaim the affected Sands associated with your mining operation is the event your permit is revoked sad financial warranty is forfeited; civil penalty, upon a this permit, the Act, is the application or :. If your mining and reclamation operations affect areas beyond the boundaries of as approved permit bousda ry, substantial eiv'-1 penalties, to you ae Dermittee ran result; ]. The Soard may suspend or rewke this permit, or assess a finding that the persittee violated the terms or conditions of the Mlnerai Rwes aatl Regulations, or that iaformatien contained your gernit misrepresent important material facts;