2024-11-22_PERMIT FILE - C1992081

• Permit No: C1992081
• IBM Index Class Name: Permit File
• Doc Date: 11/22/2024
• Section_Exhibit Name: Tab 03 Adjudication File
• Media Type: D
• Archive: No

RN17-05 ii Revised 12/17
TAB 3 TABLE OF CONTENTS Page
Rule 2.03.4 Identification of Interests 3-1

2.03.4(1) Statement of Incorporation

2.03.4(2) Names and Addresses
2.03.4(2)(a) Owner/Applicant/Operator
2.03.4(2)(b) Resident Agent
2.03.4(2)(c) Person Responsible for AML Fee 3-2

2.03.4(3) Ownership and Control
2.03.4(3)(d) Names Under Which the Applicant or Principal Shareholders
Previously Operated a Coal Mine

2.03.4(4) Current, Previous, and Pending Coal Mining Permits 3-3
Held by Applicant or Principal Shareholders

2.03.4(6)(a) Owners of Record of Surface Within the Permit Boundary
2.03.4(6)(b) Holders of Record of Any Leasehold Interest Within the Permit Boundary
2.03.4(6)(c) Holders of Record of Any Easements on the Property

2.03.4(7) Owners of Record of Surface Contiguous to the Permit Boundary

2.03.4(8) Facility Name and MSHA Number

2.03.4(9) Interests in Contiguous Lands 3-4

Rule 2.03.5 Compliance Information
2.03.5(1)(a) Statement of Non-Revocation of Permit
2.03.5(1)(b) Statement of Bond Forfeiture
2.03.5(3) List of Violations

Rule 2.03.6 Right of Entry and Operation Information

Rule 2.03.7 Statement that the Proposed Permit Area is Not Unsuitable for Operations 3-5
2.03.7(3) Ownership Waivers

Rule 2.03.8 Permit Term Information