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PART I <br />Notice of Intent No. (Assigned by Division):' -250 I 1 -Z30 -03 <br />Applicant: <br />Project Name: <br />Date: 10/06/2011 <br />COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866 -3567 <br />Individual's Name: <br />Company Name: <br />Address: <br />Telephone: ( <br />NOTICE OF INTENT TO EXPLORE INVOLVING REMOVAL OF <br />250 TONS OR LESS OF COAL RECSIVED <br />OCT "I 22011 <br />Divis;ol i vi ►�a tit, <br />r nmg <br />Blue Mountain Energy, Inc. <br />Deserado Exploration 2011 <br />Mineral Ownership: Federal X State Private <br />Surface Ownership: Federal X State Private <br />Permittee <br />Individual's Name: Scott Wanstedt <br />Company Name: Blue Mountain Energy, Inc. <br />Address: 3607 CR 65 <br />Telephone: (970) 675 -4322 <br />Permitting Contact (if different from above) <br />Individual's Name: (same) <br />Company Name: <br />Address: <br />Telephone: ( ) <br />Inspection Contact (if different from above) <br />(same) <br />Commodity Mined or Explored: <br />Coal <br />NOTE: Exploration must be conducted hi compliance with the Rules and Regulations of the Colorado Mined Land <br />Reclamation Board for Coal Mining, adopted in accordance with the Colorado Surface Coal Mining <br />Reclamation Act, C.R.S. 34 -33 -101 et se q. This form must be filled out entirely before it can be considered <br />complete. Two (2) copies of this Notice, including maps and additional attachments, should be submitted to the <br />Division of Reclamation, Mining and Safety. Please refer to Rules 2.02, 3.05, 4.07, 4.21 and 5.01 for specific <br />regulatory requirements. <br />