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'~h SGT ~~--•~~-~ ~ °, <br />~.7 c.Sf ~If -S~ [ <br />E. Ma~g-~ <br />' eus+. ~ boundaries of permit <br />'.°' 2 owners within 200' - affected surface ~ mined substance <br />3. surface features to be used in operation, existing roads, <br />~y ~ stockpiles, channels, ponds <br />/4. direction of mining <br />~ 5. permanent man-made structures within 200' of affected land <br />~6. label existing disturbance <br />R~lamation Plan Map <br />i. gradient of reclaimed slopes (post mining topography) <br />2. non-vegetated areas <br />3. ponds <br />i4. ave. thickness of overburden b topsoil replaced <br />F. List of other permits/Licenses <br />discharge <br />air quality emission <br />radioactive source <br />404 <br />wetlands <br />dam construction <br />well permits <br />highway access <br />Forest Service Plan of Operation <br />BLM <br />County zoning <br />City zoning. <br />,/Storm Water <br /> <br />~~. Source of legal right to enter <br />1, H./ Municipalities within 2~ miles <br />~/~. Proof of filing w/ County Clerk & Recorder <br />1. receipt or affidavit - date applic. placed w/ clerk & recorder <br />,~ J. Proof of Mailing Notices of Permit Application <br />1. Board of County Commissioners <br />2. Board of Supervisors of SCD <br />a. submit proof of applic at time of submittal to Division <br />~, o..'c .v./ ~'/~.._ Zip <br />NEWSPAPER PUBLICATION <br />WITHIN 10 DAYS OF FILING W/ DIVISION (when considered complete) <br />COMMENT PERIOD - 10 days from date of publication <br />.~/j!L. lr ..(~ <br /> P ~a ~; J <br /> <br />v l: '~ . <br />.. <br />