Laserfiche WebLink
ML''IED LAND RECLAtfATION <br />4/77 ~ ~ III IIIIIIIIIIIIIIII <br />Regnnular (112) Permit Application Checklist <br />File ao. 77-S7a~ Name ~Cpl~~y~r>Y,~ ~G~-~f"~~"{'-bate of Filing (Completeness) :_ <br />ITEid COMPLETE ADEQUATE COMMENTS <br />Application Form <br />1. dame of operation <br />2. ;tame of applicant <br />3. Address 6 phone {local offices) <br />4. Address 6 phone (gen'1. offices) <br />5. Person to contact <br /> <br />6. Parent corporation (if any) i <br />7. Surface owners <br />3. Pfineral owners <br />i <br />9. Type of mine/substance <br />.0. General location ~ elevation ~ I <br />.1. County ~ <br />2. Acreage <br />.3. Fee ~ ~ <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 <br />*faps ~ Exhibits <br />1. Legal description <br />v/ <br />2. Index map <br />3. Pre-mining 6 mining plan map <br />4. Ptining elan - a) timetable <br />- b) depth 5 thickness of ore <br />aoay <br />