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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY f� <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 COLORADO <br />p r V t 3 l O N OF <br />Phone: (303) 8663567 <br />L <br />FAX (303) 832.8106 MINING <br />ON <br />LIMITED IMPACT OPERATION (110(2)) <br />SAFETY <br />RECLAMATION PERMIT <br />APPLICATION FORM RJecielV <br />C ED <br />MAY o � <br />CHECK ONE: New Application {Rule 1.4) Conversion Application (Rule 1.1 b)vz <br />Permit # M- - (provide for conversions of existing permits) Ml NI N�ANp S4 M4T /ON <br />qpz� <br />The application for a Limited Impact Designated Mining Operation Reclamation Permit contains three major parts: (1) the application <br />form; (2) Exhibits A -J, any required sections of Exhibit S and Geotechnical Stability Exhibit, as required by the Office, and outlined in <br />Rules 6.1, 6.2, 6.3, 6.4.19 and 6.5; and (3) the application fee. Wben you submit your application, be sure to include one (1) signed an <br />original and one (1) copy of the application foam, two (2) copies of Exhibits A -J, appropriate sections of 6.4.19 Exhibit S and 6.5 <br />(Geotechnical Stability Exhibit), as required, and a check for the application fee described under (4) below. Exhibits should not be bound <br />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 processing, please provide the information <br />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. Applicant/operater or company name (name to be used on the permit): Lockland, LLC <br />1.1 Type of organization (corporation, partnership, etc.): Lockland, LLC <br />2. Operation name (nit, mine or site name): Hopemore Shaft <br />3. Permitted acreage (new or ezrstin¢ site): 9.9 _ permitted acres <br />4. Fees: <br />4.l New Application $1,006.00 application fee <br />4.2 Amendment Application (from 1.10(2)) <br />4.3 Conversion Fee (from 110d to 110(2), (Rule 1.11.2(2)) $1.725.00 conversion fee <br />5. Primary commodities) to be mined: Gold, <br />6. Name of owner to the surface of affected land: Robert W. Calder /U.S. BLM <br />7. Name of owner to the subsurface rights of affected land: Robert W. Calder <br />8. 1�2e of mining operation: Surface W1 Underground -a In -situ <br />office of office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />