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FGEIvED <br />L2MITID IMPACT OPERATION (110(2)) <br />APP~L~IC{ATTIONPFORM MAY 0 71887 <br />CK ONE: ~_ New Application (Rule 1.4) _ Amendment App licatip({,_lC_. R.S.-E3 g= 72,~r~.0) <br />Conversion Application (Rule i.il) vvNN00I1DD~~0iMlTl fd156Uou~uyy <br />Permit ~ M- - (provide for amendments and conversions o£ <br />existing permits) <br />The applicacion fora Limited Impact Mining Operation Reclamation Permit contains three major <br />parts: (1) the application form; (2) Exhibits A-J, Addendum i, any sections of Exhibit S and <br />Geocechnical Stabili~y Exhibit, as requited 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 applicacion, be sure <br />to include ore (1) sicned and notarized original and one (1) copy of the application form, <br />two (2) copies of exhibits:.-J, appropriate sections of 6.4.19 Exhibit S and 6.5 <br />(Geotechnical Stability Exhibit), as required, and a check for the application fee described <br />under (4) below. Exhibits should not be bound or in a 3-ring binder; mays should be folded <br />co 8 1/2" Y li" or 9 1/2" X 14" sire. To exped'_te processing, please provide the information <br />in the format and order described in this form. <br />r~ ~~ v~ <br />-------------------------------------------------------=---------------------------------- <br />G'c_"TERAL O2ERATiCN INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/ooera[or or company name (name co be used on permit): <br />Energy Fuels Nuclear, Inc. <br />1.1 Type of organiaac_on (corporation, partnership, etc.): Colorado Co oration <br />1.2 I.R.S. Tax iD No. or Social Security Number: P~4-1~7?A57 <br />Operation name (plc, mire or site name): plan 4 Shaft <br />3. Permitted acreage (rew „r eristi.^.a sicel <br />3.1 Chance .n acreage (+ or -) <br />Total Acreace .n Pe -iic Area <br />8.4 permitted acres <br />acres <br />R•~ acres <br />Fees: <br />a.. New App l:cac:er. 5975.00 application fee <br />-,mendment ?ee (C.R.S. 34-3<.5-1'_5 (II)) 55'5.00 acniicat:cn °ee <br />4.2 Conversio.^. Zee l`_rom 110d co 110 5975 00 cor.-re rsion =ee (2u le '_.11.2(211 <br />5. Primary commoditie(s) to be mined: Uranium !'anadium <br />c. Name cf owner of the subsur`_ace rights of affected land: ~iSHLM <br />,. Name of owner of the sur=ace of affected Land: USB Li4 <br />a. Type of mining onerac.on. Sur=ace x Underground in-s:tu <br />9 Lo careen -n_'ormac.on. The center of the area where the ma'crcty u: mininc wi <br /> occur Les in: <br /> COtT.ITY: Montrose <br /> PRT_NCI?AI. t'=ZT_~?:+:: i~.e ck one) oth (CO'_oracol '~ 1J ~`. (New c_e xicc) Ute <br /> SECTION (write nut~~er) S "'Q <br /> TCWDiS -SIP lw-i_e nvrher a^-d check di re ctic^) : T •+r. Y :~o r-.`. Scut' <br /> RA;]GE (writa c~-M,er and cnec~ direcu cnl R i7 Easc a west <br /> QU.'+RTEt SEC:'=CN (c'e ci: ore) ~_ :.'L N5: SE S^ <br /> QUARTErz; QUSZTE2 SE~:_.ON (c`ec~ ore) \c [IW S3 x c„ <br /> GE]iE?_~:.. DESC'£PT_C.+: ( t :e z~:=-er o= .r._'_es ant ,._rectcon i-cn c :e nearest town ant <br /> the 3Cprpxl.^.13t2 e_a•:ac_on) Rooroxzmatel^ 10 mi_=s 'rest o£ '.Iaturita, CO at an <br />• elevation of 5,900 ft. <br /> <br />