2017-05-10_REVISION - C1981012 (3)

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P`l Lu �- AVS CHECK REQUEST Permit No.: IC - $ - 01 Z I Mine Name: I \L; C- W ` Permit Action; N-06 Applicant: I �5(L V rnu V MSHA ID #: 105-0Gj ISpecialist: t7 ADEQUACY Request Date 11 Attach a current list of the owners and controllers for the applicant and the operators, as required by Rule 2.03.4, Identification of Interests. 2 T)e t ew+rwl l If applicable, attach a list of permits held by the applicant in otherstates, by numbers and state codes. Date of Check Application Yes Adequate? No AVS Check Result: 2"D ADEQUACY, IF APPLICABLE Request Date 2.7 —70 _0I Attach any updated information. Application Adequate? Yes No AVS Check Result: 3RD ADEQUACY, IF APPLICABLE Date of Check Attach any updated information. Application Yes Adequate? No AVS Check Result: PROPOSED DECISION - REQUEST 3-5 DAYS PRIOR Request Date Date of Check AVS Check Result: PERMIT ISSUANCE - REQUEST 3-5 DAYS PRIOR Request Date Ownership and Control Information Current, per Rule 2.03.4(5)? Yes No, revised information is attached Date of Check Permit Application and AVS Consistent? Yes No, Revision Required AVS Check Result: DECISION FINAL Date Final: Date Entered in AVS: