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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 HART) ROCK/METAL MINING <br />REGULAR OPERATION (112) <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: There is a File Number Already Assigned to this Operation <br />New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />w • Conversion Application (Rule 1.11) <br />Permit # M- 1983 _ 011 _ • (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 />1. Applicant /operator name: Mt. Elbert Mining Co., L.L.C. <br />4. Fees: <br />4.1 <br />4.2 <br />4.3 <br />4.4 <br />4.5 <br />Office of <br />Mined Land Reclamation <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1.1 Type of organization (corporation, partnership, etc.): corporation <br />2. Operation name (pit, mine or site name): Willow Creek Mine <br />3. Permitted acreage (new or existing site): <br />3.1 Change in acreage (-I- or -) <br />3.2 Total acreage in Permit area <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: Gold <br />7. Name of owner of subsurface rights of affected land: Mt. Elbert Mining Co., <br />If 2 or more owners, refer. to Exhibit O. <br />8. Type of mining operation: X Surface <br />STATE OF COLORADO <br />Underground <br />9.5 <br />33.88 <br />43.38 <br />permitted acres <br />acres <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: Mt. Elbert Mining Co., L.L.C. , US Forest Service <br />Phillips Mining Company <br />In -situ <br />Office of <br />Denver • Grand Junction • Durango <br />Active and Inactive Mines <br />