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7 <br />ile <br />`Q:IED L?.~`ID BECLE~MATZON '-~~.tp('7~' ''~ <br />LPa1IT"r.D L*SPACT A.tiiD SF£C2.4L 20-OAY PERialT AP?LZCAT20N C'3EC9ZIST '~ <br />No.7rd'/~dt V •~~,,,.` Date of Filing (Completeness) <br />ITS COiZPLETE ~ AD£QIIAT:. COMSEidTS <br />Application Fora <br />L. Name of operation <br />2. Name of applicant/operator ~ <br />3. Address & ahoae (local offices) ~^ <br />4. Address & phone (general offices) ~ / <br />5. Person to contact ' <br />5. Surface otmers r,/' I 4 <br />7. 2fiaeral owners /' <br />8. Type of Dine/substance ` <br />f / <br />I <br />9. General location £e elevation ~ ~/ ~ <br />20. County v~ <br /> <br />21. Acreage <br />i <br />~,~ <br />f <br />I2. c'ea -.-,yeb-~ . ~ <br />13. ?resent land use ~ ~ <br />24. Proposed future use I <br />` / ~ <br /> <br />L. Si,Qnature L f <br />' ~v~c S.;f./ , <br />ko7 <br /> <br />maps and Exhibits <br />1. E.~ibit A - Legal description -~ <br /> <br />~^ <br />Z.. Exhibit 3 - ?Li.aiag. nlaa / ~, i <br />3. c'.xfiibit C - :~aa <br /> <br />~. Exhibit D - 'dildlifz;~Tater Resources, <br />7egetatioa and Soils izfor~/ <br />motion <br /> <br />'7'~~w` <br />f f <br /> <br />r <br />~ <br />5. Exhibit E - Reciat:ation plan ~ / ~.~' ~ ~,,,c/~ ~51 ~s~r-a°~ <br />