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Apr-11-00 01:14P • <br />• <br />Form 551(11 <br />P°~> 1993) UNITED STATES <br />DEPARTMENT OH' 7'HE INTERIOR <br />BL1Rf,AlJ OF~ LAND MANAGEMENT <br />FREE USE APPLICATION AND PERMIT <br />VEGETATIVE OR MINERAL MATERIAL <br />APPLICATION <br />Namc of applicant <br />Kind of material <br />Addrets (nthrde np rode) <br />P.06 <br />FCIRM gk'['kOVF.i) <br />uMCS N0. tract-WUl <br />Fipves: May 31, 1996 <br />permit Numher <br />~'c'C - ~ .~ S.JG <br />F.tpiracitm Dale <br />O/- 06 -~Id7 <br />District <br />~'Q - ~~Q Q 0 <br />~~E~EsCr ) p ~~ <br />Estimated yuatditY i~._. ~. ~... <br />Give legal land docription ' <br />TOWNSHIP RANGE 5lC:1'IUN $IIAIIIVItiIfIN <br />y S. /oyw /3 5ENw , S'w ivE <br />sl CERTIFY Thst 1 am a ritiren n(the United State, and of the age of mgority is the State m whiuh I reside. <br />I FURTHER CERTIFY Thal the autemcnu made by me in chi+appligtion arc wr, complete, and turtecl to the beet n(my knowledge and Lw'llcf and art made in good <br />faith. <br />r x - <br />I i11e la U.5.C. Settioo 1001, malts it • crime fnr.ny pennn knowingly and wiutWy to make m any JcpanmCtt ur aaeocy of the United Slalc..ny fsl.e. fiailiom. or fraudulent rtoiimentr or <br />nptc+rnlennnn u w am moor within iu jWUdictroo. <br />PERMIT <br />SPEGAL CANOIT(ONS <br />Thu permit i+ hereby ilsoed for the msteriala a plied (nr but may be canceled if it appear [hu tfiis pcrmil was usual emmenurly or the ttnro ur cnndinnns coNaiaW <br />herein are nut observed. It shall bt subject to the follawrag spmil conditions: <br />,SF~ ~ Kfjldrlr~" <br />K'on>ervahon Dractieer nruv he cai rigid nm us prurided hyal C'FR SSI I 1-1(h), .2.Hc), 1T+ prrmistre sAW clean up all work arcu nnJ shall remove or direr+t of nll refuse <br />and .l-3; ruultin lrnm she <br />g permitteeY apereticna, <br />Hyuipment. penonalpmpcny,.nd improvemeon msm lr rammed within amety(9r1) This permitisivuai under the Aet u[suly 31, 1917, as amended. and 43 l1 ti.C. nnJ <br />days after cayirauon date L3 CFR 5511.3-5); 1201, and under the free use privJeae of the Act of May Ia, Ia9a (Alaska only). <br />Aoy use of the +urft< u( the lands iarotved in this permit shW he rash u not /n An mnual npmt inJiwtiog theamnunt (cu. ydr. unoasJ of materal rourn.W mrur be <br />inler(erc with any miningdaimmblea webs provirians nfS¢tionduf the Ac[oUuly Iled wtitA she Dis4;n01<tz uo Neasmsvcrurydue of [hr petmu, or within tlrorv(.fq) <br />21, 195$ 1)0 U.S. L'. al3): days a/Irr permit a:piratinn (Alaska oNy). <br />_._~_ _ _. (Dalel _ (Signaturt of Amhoriacd Ulfioer) <br />APPLCANT <br />I HEREBY AOR EETU COMPLY W ITH the apaial conditions as set forth below, I ('I'.R~I IFY Tha[ lhe~ (a) materials lu be removed arc to he a+cfl for rAC purpose nolW <br />shove; (h 1 none ref cfie matenals removed aRto bt sold or barurcd; (e) femovil al materials can begin only upon receipt of an approval copy n} this Derttttt; and, (d) the <br />authnrired officer is to be no[itied upon completion of removal. <br />