PERMFILE42473

• Permit No: M1979210
• IBM Index Class Name: Permit File
• Doc Date: 12/3/1979
• Doc Name: APPLICATION CHECKLIST
• Media Type: D
• Archive: No

7/7$ ~ / ~• APPLICATION CM ECKL I S-T' G~ ~ III III III IIIIIII III
LIMITED IMPACT (110) v NAME~~C~ °~ J99. ~~.. ,r -~~o
SPECIAL 10-DAY (111} _ COMPLETE (FILED) GATE ~o~_ 3 ~ 9 7
ITEM COMPLETE ADEQUATE COMMENTS
Application Form:
1. Name of operation
~~
2. Name of applicant/operator ~-
3. Address 6 phone, local ~.
4. Address b phone, general ~
5• Person to contact
v
6. Surface owners ~~
7. Mineral owners
L.
8. Source of legal right-to-enter
9• Type of mine/substance
10. General location & elevation ~/
11. County v
12. Acreage
13. Fee
/"
14, Present land use !~
15• Proposed future use
v
16. Signature Li
Maps and Exhibits

EXHIBIT A - Legal Description
L.
EXHIBIT B - Mining Plan ~
EXHIBIT C - Map ~
EXH IBIT D - Wildlife, Water Resources,
Vegetation, Soils Information L/