2013-06-05_PERMIT FILE - M2012052 ‎(4)‎

• Permit No: M2012052
• IBM Index Class Name: PERMIT FILE
• Doc Date: 6/5/2013
• Doc Name: Completed 110d Permit Application
• From: Providence Mining, LLC
• To: DRMS
• Email Name: TC1
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY
DepartInent of Natural Resources ,A/� r% �� / Zi O
1313 Sherman St., Room 215
Denver, Colorado 80203
Phone: [phone]
FAX: [phone]
DESIGNATED MINING
LIMITED IMPACT (1104) OPERATION
COLORADO
DIVISION OF
RECLAMATION
MINING
SAFETY
Bill Ritter, Jr.
Governor
RECLAMATION PERMIT APPLICATION FORM Harris D. Sherman
Executive Director
Ronald W. Catiany
Division Director
CHECK ONE: New Application (Rule 1.4) D Amendment Application (Rule 1.8 or 2.10) Natural Resource Trustee
Conversion Application (Rule L 11)
Permit # M- - - (provide for Amendments and Conversions of existing permits)
The application for a Limited Impact (I IOd) Designated Mining Operation Reclamation Permit contains three major parts: (1) the application
form; (2) Exhibits A -J, Exhibit L, Exhibit T, the Geotechnical Stability Exhibit, the Emergency Response Plan, and Addendum 1, as required by
the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.4.20 6.5, 8, and 1.6.2(1)(b); and (3) the application fee. When you submit your application, be sure
to include one (1) signed and notarized Original and one (1) copy of the application form, two (2) copies of Exhibits A -J, Exhibit L, Exhibit T, the
Geotechnical Stability Exhibit (Rule 6.5), the Emergency Response Plan (Rule 8), and Addendum I (Rule 1.6.2(1)(b)), as required, and a check for
the application fee described under (4) below. Exhibits should NOT be bound or in 3 -ring binders; maps should be folded to 8 2" X 11 " or 8 2" X
14" size. To expedite processing, please provide the information in the format and order described in this form.
Office of Office of
Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines
GENERAL OPERATION INFORMATION
Type or print clearly, in the space provided, all information described below.
1. Applicant/operator
or company name (name to be used on Permit): Providence Mining, LLC
1.1
Type of organization (corporation, partnership, etc.): Limited Liability Cormpany
1.2
I.R.S. Tax ID No. or Social Security Number: 20- 1581874
2. Operation
name (pit. mine or site name): Providence Mine
3. Permitted
acreage (new or existing site): P, 41— 9.93
permitted acres
3.1
�> d
Change in acreage ( +) E®
acres
Total Acreage in Permit Area , ; i rt" ' 9.93
acres
)91 3
4. Fees: (Rule 1.5)
DIVISION
4.1
AM $2.875.00
New Application MINI ATI ON
NGAND
AND
application fee
4.2
s
SAF
Amendment Fee (operations existing as of 06/30/94) ETY _ -- $1,725.00
application fee
4.3
Amendment Fee (operations permitted from 07/01/94) $2300.00
application fee
4.4
After July 1, 1995, to convert a 110(1),110(2) or a 110 to a 110(d), a new application form for a I l Od must be submitted, along
with an application fee of $2,975.00 (Rule 1.11.2(2)).
5. Primary commodities to be mined: Gold Silver
0 II 0
6. Type
of mining operation: Surface Underground In -situ
Office of Office of
Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines