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<br />Y <br />contacbCase manager: _ <br />Petitioner should be a single ownership entity who owns the property. If property <br />landowner must co-sign application or submit a letter stating no objection. <br />N <br />provide the following: <br />Cover applic 'on signed by all petitioners <br />Le al D ti <br /> <br /> <br />g escnp <br />Area Map* <br />Vicinity Map* <br />Existing Conditions Ma * <br />Phasing plan sketch <br />Cross-section of cuts and fills <br />Reclamation plan sketch showin e <br />Certificate of liability insurance $6~ <br />Names and mailing addresses on m <br />property on which site is located as <br />Other: <br />hed Site Plan <br />Guidelines <br />and final conto~rrs and landscaping <br />with Routt C©iinty as additional named insured <br />labels of all property owners adjacent to the <br />find in assessors records. Two sets are required. <br />Existing Conditions Map and Narrative <br />1. Area map. (Insert from Site Plan scription) See Attache <br />2. Surface owner: Twentymile C al Company (a wholly-owned Peabo Energy subsidiary); State of <br />Colorado, Board of Land Co missioners; See Attached for Right-of-En access agreements. <br />3. Mineral owner if mi ral exploration: Stare of Colorado, Board of Land mmissioners. See <br />Attached for coal c trol agreements. <br />4. Lease intere s: N/A <br />5. Coven ts: (please attach): N/A <br />6. ter existing permit approvals: Notice of Intent (NOI) through the Colorado Division of <br />Reclamation, Mining and Safety (approval pending), Exploration Permit through State of Colorado, <br />Board of Land Commissioners (approval pending). <br />Project DescriptionlNarrative <br />Guidelines for submittal <br />1. Describe type of project: Project involves drilling and coring of exploration lwles and subsequent <br />reclamation of all exploration related disturbance. A total of 2 holes will be drilled within the <br />project area. The drillholes will range from 1,100 to I,ISOfeet in depth. <br />2. Location and type of on-site facilities/structure: Except for the temporary setup and use of the <br />drill-rig there will be no facilities/structures associated with the project. <br />