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OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources MAY 19.1011 RF_c?gVFFD <br />1313 Sherman 5t, Room 215 O n 7011 <br />Denver, Colorado 80203 \ r0' ?1 Division of ?teclamaGonMAY 19 G J <br />Phone: (303) 866.3567 Wing and Saf* <br />FAX: (303) 832-8106 J HARD ROCK/METAL MININGDivtSion sor r ou;;azr,tLjtjon <br />Mining and Sag':ty <br />REGULAR OPERATION (112) <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: 11 There is a File Number Already Assigned to this Operation <br />New Application (Rule 1.4.5) El Amendment Application (Rule 1.10) <br />GOLD <br />Conversion Application (Rule 1.11) - <br />Permit # M- (provide for amendments and conversions of existing permits) <br />The application for a Regular Operation Reclamation Permit contains three major parts: (1) the application form; (2) Exhibits A-S, <br />Geotechnical Stability Exhibit and Addendum 1; and, (3) the application fee. When you submit your application, be sure to include <br />one (1) completed, signed and notarized gray original and one (1) copy of the completed application form, two (2) copies of Exhibits <br />A-S, the Geotechnical Stability Exhibit, and Addendum 1, and a check for the application fee described under Section 4 below. <br />Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1/2" X 11" or 8 1/2" X 14" size. To expedite <br />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 />1 <br />2. <br />Applicantloperator name: JUBILEE VENTURE, LLC <br />1.1 Type of organization (corporation, partnership, etc.): PARTNERSHIP <br />Operation name (pit, mine or site name): EAGLE MINE <br />3. Permitted acreage (new or existing site): <br />3.1 Change in acreage (+ or -) <br />3.2 Total acreage in Permit area <br />4. Fees: <br />4.1 <br />4.2 <br />4.3 <br />4.4 <br />4.5 <br />New Application <br />New Quarry Application <br />Milling Application (Non-DMO) <br />Amendment Fee <br />Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: <br />13.5 permitted acres <br />acres <br />COLORADO <br />DIVISION OF <br />RECLAMATION <br />MINING <br />SAFETY <br />acres <br />$2,156.00 application fee <br />$2,674.00 quarry application <br />$3,565.00 milling application <br />$1,783.00 amendment fee <br />$1,725.00 conversion fee <br />6. Name of owner of surface of affected land: U.S. ADMINISTRATED BY BUREAU OF LAND MANAGEMENT <br />7 <br />8. <br />Name of owner of subsurface rights of affected land: U.S. <br />If 2 or more owners, refer to Exhibit O. <br />Type of mining operation: X Surface <br />Underground <br />In-situ <br />Office of <br />Mined Land Reclamation <br />Office of <br />Denver • Grand Junction .• Durango Active and Inactive Mines <br />