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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX; (303) 832-8106 <br />REGULAR (112d) DESIGNATED MINING OPERATION <br />RECLAMATION PERMIT <br />APPLICATION FORM. <br />CHECK ONE: - New Application (Rule 1.4.5) _ Amendment Application (Rule 1.10) <br />X Conversion Application (Rule 1.11) <br />Permit No. M-2008.012 (provide for amendments and conversions of existing permits) <br />COLORADO <br />D I V I S I O N OF <br />RECLAMATION <br />MINING <br />SAFETY <br />Bill Ritter, )r <br />Governor <br />Harris D. Sherman <br />Executive Director <br />Ronald W. Cattany <br />Division Director <br />Natural Resource Trustee <br />The application for a Regular (112d) Designated Mining Operation Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A-T, Geotechnical Stability Exhibit, the Emergency Response Plan, and Addendum 1, as required by the Office, and <br />outlined in Rules 6.1, 6.2, 6.3, 6.4.19, 6.5, 8.0, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be sure <br />to include one (1) signed and notarized original and four (4) copies of the application form, five (5) copies of Exhibits A- T, Rule 6.5 <br />Geotechnical Stability Exhibit, the Emergency Response Plan, Addendum 1, and a check for the appropriate application fee (described <br />under Section (4) on Page 2). Exhibits should not be bound or in a 3-ring binders; maps should be folded to 8 %2" X i I" or 8 %z' X 14" <br />size. To expedite processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />Applicant/operator or company name (name to be used on permit): <br />Nuvemco. LLC <br />1.1 Type of organization. (corporation, partnership, etc.): _LLC <br />1.2 LR..S. 'l'ax ID No. or Social Security Number: , - <br />Operation name (pit, mine or, site name): Last Chance-Mine_____- <br />3. Permitted acreage: (new or existing site) 8.75 permitted acres <br />3.1 Change in acreage (t) 4123 acres <br />3.2 'T'otal acreage in Permit area 49.98 acres <br />Office of Office of <br />Mined Land Reclamation Denver • Grand }unction • Durango Active and Inactive Mines