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DIVISION OF MINERALS AND GEOLOGY <br />CONSTRUCTION MATERIALS <br />Regular (112) Mining Operation <br />Application Worksheet/Checklist <br />New App: X Amendment App: <br />Operator: Moffat Limestone Co., Inc. ,/ <br />Mine Name: Junipe r Mountain travel <br />Conversion App: <br />Mine ID: M-2003-073~/ <br />Submittal Date: o9/ls/2oo3 / <br />APPLICATION FORM (Rule 1.6.2 and 1.6.3): Application to be considered as a Nem 1120 <br />App <br />ITEMS 1 2 3 4 5 6 <br />COMPLETED Acreage must <br /> be corrected <br /> X X X X X X <br /> Corrected <br /> Paqe 1 of <br /> App Rec <br /> 08/15/03 <br />ITEMS <br />COMPLETED 7 8 9 10 11 12 <br /> X X X X X X <br />ITEMS 13 19 Description Responsibilities Signature <br />COMPLETED of of a <br /> Amendment permittee <br /> X X X X <br />MAPS and EXHIBITS (Rule 6.2) ADEQUACY COMMENTS <br />EXHIBIT A - 6.4.1 - LEGAL DESCRIPTION: X <br />EXHIBIT B - 6.4.2 - INDEX MAP: X <br />