Laserfiche WebLink
4 / i 7 • MINED LAND RECLAMATION ~ II I I II I II I II IIII III <br />Regular (112) Permit Application Checklist <br />File PIo. S ~r Name l/G~ ~ C, O ~i.~ c.. Date of Filing (Completeness) <br />-2Z <br />iTEia COMPLETE ADEQUATE COP4SENTS <br />Application Form <br />1. i4ame of operation / / <br />v <br />2. name of applicant <br />3. Address fi phone (local offices) ~ <br />4. Address fi phone (gen'1. offices) <br />5. Person to contact <br />6. Parent corporation (if any) ~ <br />7. Surface owners ~ <br />3. Mineral owners <br />i <br />9. Type of mine/substance <br />0. General location fi elevation ~ <br />1. County ~ <br />2. Acreage <br />3. Fee i <br />i <br />4. Present land use <br />.5. Surrounding land uses ~ <br />.6. Proposed future use <br />7. Other mining permits <br />.8. Signature <br />.9. Prohibited Lands Statement v <br />'Maps fi Exhibits <br />1. Legal description <br />?. Index map <br />3. Pre-mining fi mining plan map I <br />4. Paining plan - a) timetable ~ <br />- b) depth fi thickness of ore ~ <br />ooay <br />