2015-11-30_PERMIT FILE - P2015021

• Permit No: P2015021
• IBM Index Class Name: PERMIT FILE
• Doc Date: 11/30/2015
• Doc Name: Application Form 2
• From: Michael Royer?
• To: DRMS
• Email Name: MAC
• Email Name: WHE
• Media Type: D
• Archive: No

VII. TERMS AND CONDITIONS
A. ' If a bond is required, it must be furnished before approval of the plan of operations.
B. Information provided with this plan marked confidential will be treated in accordance with the agency's
;laws, rules, and regulations.
C. Approval of this plan does not constitute certification of ownership to any person named herein and/or
recognition of the validity of any mining claim named herein.
D. Approval of this plan does not relieve me of my responsibility to comply with other applicable state or
federal laws, rules, or regulations.
E. If previously undiscovered cultural resources (historic or prehistoric objects, artifacts, or sites) are exposed
Os a result of operations, those operations will not proceed until notification is received from the Authorized
fficer that provisions for mitigating unfo;•eseen impacts as required by 36 CFR 228.4(e) and 36 CFR 800
ave been complied with.
F. his plan of operations has been approved for a period of or until (mm/dd/yy) . A new or
evised plan must be submitted in accordance with 36 CFR part 228, subpart A, if operations are to be
continued after that time period.
VIII. OP _FATING PLAN ACCEPTANCE
II We have reviewed and agreed to comply with all conditions in this plan of operations including the
requi ed changes, modifications, special mitigation, and reclamation requirements.
j11 We understand that the bond will not be released until the Authorized Officer in charge gives written
appr al.
Signature of ElOperato,
UAuthorize l f-1/ resentative)
(Date)
mm/dd/
IX. OPERATING PLAN APPROVAL
(Name)
Signature of (Authorized Officer)
(Title)
(Date)
(mm/dd/yy)
Burden and Non -Discrimination Statement
According to the Paperwork Reduction Act of 1995, an agency may not conduct o.` sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The valid OMB control number for this information collection is 0596-00:2 The time required to complete this information collection is estimated to average 12 hours per response,
including the time for reviewing instructions, searching existing data sources, gatherin7 and maintaining the data needed, and completing and reviewing the collection of information.
The U.S. (Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital
status, fanjriial status, parental status, religion, sexual orientation, genetic inform ;5or, political beliefs, reprisal, or because all or part of an individual's income is derived from any public assistance.
(Not all prohibited bases apply to all programs.) Persons with disabilities who rec uiree alternative means for communication of program information (Braille, large print audiotape, etc.) should contact
USDA's TARGET Center at 202-720-2600 (voice and TDD).
To file a ccimplaint of discrimination, write USDA, Director, Office of Civil Rights, 1460 Independence Avenue, SW, Washington, DC 20250-9410 or call toll free [phone] (voice). TDD users
can contact USDA through local relay or the Federal relay at [phone] OW) o1(866) 377-8642 (relay voice). USDA is ar equal opportunity provider and employer.
(If more space is needed to fill out a bock of information, use additional sheets and attach form)
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