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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 <br />STATE OF COLORADO <br />REGULAR (112d) DESIGNATED MINING OPERATION <br />RECLAMATION PERMIT <br />APPLICATION FORM <br />CHECK ONE: New Application (Rule 1.4.5) Amendment Application (Rule 1.10) <br />Conversion Application (Rule 1. 11) <br />Permit No. M- 1978 _116 (provide for amendments and conversions of existing permits) <br />COLORADO <br />D I V I S ION OF <br />RECLAMATION <br />MINING <br />—&I— <br />SAFETY <br />The application for a Regular (112d) Designated dining Operation Reclamation Permit contains three major parts: (1) the application form; <br />(2) Exhibits A -T, Geotechntcal Stability Exhibit, the Emergency Response Plan, and Addendum 1, as required by the Office, and outlined in Rules <br />6.1, 6Z, 6.3, 6.4.19, 6.5, 8.0, and 1.6.2(l)(b); and, (3) the application fee. When you submit your application, be sure to include one (1) signed and <br />notarized original and four (4) copies of the application form, five (5) copies of Exhibits A -T, Rule 6.5 Geotechnical Stability Exhibit, the <br />Emergency Response Plan, Addendum 1, and a check for the appropriate application fee (described under Section (4) on Page 2). Exhibits should <br />not be bound or in a 3 -ring binders; maps should be folded to 8 '' /,' X 11" or 8 ''A" X 14" size. To expedite processing, please provide the <br />information in the format and order described in this form. <br />2. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />Applicant/operator or company name (name to be used on permit): <br />Cotter Corporation (N . S ,. L . ) <br />1.1 Type of organization (corporation, partnership, etc.): Corporation <br />1.2 I.R.S. Tax ID No. or Social Security Number: 85- 0125530 <br />Operation name (pit, mine or site name): SM -18 <br />3. Permitted acreage: (new or existing site) <br />3.1 Change in acreage ( +) <br />3.2 Total acreage in Permit area <br />14.90 permitted acres <br />6.29 acres <br />21.19acres <br />Office of Office of <br />Mined Land Reclamation Denver . Grand !unction • Durango Active and Inactive Mines <br />