2009-06-01_REVISION - M1978039HR

• Permit No: M1978039HR
• IBM Index Class Name: REVISION
• Doc Date: 6/1/2009
• Doc Name: Application Form
• From: Denison Mines
• To: DRMS
• Type & Sequence: AM1
• Email Name: RCO
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources
1313 Sherman St, Rim 215 `4e
Denver, COlorado'80203 e
D COLORADO
1 331 O N o f
Phone: [phone]
- RECLAMATION
FAX: [phone] M I N I NG
«,U? ® SAFETY
®% SIGNATED MINING
IMPACT (110d) OPERATION Bill Riau, Jr.

WAMATION PERMIT APPLICATION FORM
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CHECK ONE: B New App
ication (Rule 1.4) Natural Resource Trustee
Conversion Application (Rule 1.11)
Permit ff M-1978.039 - H R (provide for Amendments and Conversions of existing permits)
The application for a Limited Impact (I I Od) Designated Mining Operation Reclamation Permit contains three major parts: (1) the application
form; (2) Exhibits A-J, Exhibit L, Exhibit T, the Geotechnical Stability Exhibit, the Emergency Response Plan, and Addendum 1, as required by
the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.4.20 6.5, 8, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be slue
to include one (1) signed and notarized Original and one (1) copy of the application form, two (2) copies of Exhibits A-J, Exhibit L, Exhibit T, the
Geotechnical Stability Exhibit (Rule 6.5), the Emergency Response Plan (Rule 8), and Addendum 1(Rule 1.6.2(1)(b)), as required, and a check for
the application fee described under (4) below. Exhibits should NOT be bound or in 3-ring binders; maps should be folded to 8 2" X 1 l " or 8 2" X
14" size. To expedite processing, please provide the information in the format and order described in this form.
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, all Information described below.
I. Analicant/operator or company name (name to be used on permit): Denison Mines (USA) Corp.
1.1 Type of organization (corporation, partnership, etc.): Corporation
1.2 I.R.S. Tax ID No. or Social Security Number:
2. Operation name (pit, mine or site name): St. Jude Mine
3. Permitted acreage (new or existine site): 9.75 permitted acres
3.1 Change in acreage (+) 0.0 acres
Total Acreage in Permit Area 9.75 acres
4. Fees: (Rule 1.5)
4.1 New Application $2.875.00 application fee
4.2 Amendment Fee (operations existing as of 06/30/94) $1.725.00 application fee
4.3 Amendment Fee (operations permitted from 07/01/94) $2300.00 application fee
4.4 After July 1, 1995, to convert a 110(1),110(2) or a 110 to a 110(d), a new application form for a 11 Od must be submitted, along
with an application fee of $2.875.00 (Rule 1.11.2(2)).
5. Primary commodities to be mined: UraniumNanadium
6. Type of mining operation: II Surface a Underground II In-situ
Office of Office of
Mined Land Reclamation Denver • Grand junction • Durango Active and Inactive Mines