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_~--~• <br />~INED LAND WILDLIFE QUESTIONAIR~ <br />for limited impact and select regular mine applications <br />1. Name of Company/Mine:- ~y/chci' ~cyq~-cgegY+C <br />2. Name/Address/Phone of Contact Person: ~~ay ~~ ~ ~ p ~Y J r <br />v~i-v Foii•n/41 ~.~_ P~_ 3o7-g~S G-2e7/ <br />3. Location of Mine: T 9•~/O S•, 2,77W,~ Scc3, Zvi ~ 39~ <br />(County, Township, Range, Section to nearest quarter quarter; Exhibit A-MLR appl.//) <br />4. Nearest Town/General Loc.a[ion: ~i/"~/t~l~ v~sc /s7i,/c ~~~. e ~ S~,IY <br />5. Land Ocmership (Circle) 1. Private 2. BLM 3, USFS 4. Other <br />• <br />6. Present Land Use: ~~rlv C <br />7. Proposed Final Land Use: ~c~c%~ ~.sc-~s <br />__~ <br />8. Type of Operation: l.~urface 2. Underground <br />9. Minerals being mined: f7I4 c c •-- ~o.•~--+~1 <br />10. Number and Description of Surface Acres Disturbed by Mining/not inFluding roads <br />(Exhibit D-MLR): <br />11. Miles of roads to be constructed: <br />12. Life of Mine (years):- / b <br />13. Description of Operation and Reclamation -- Additional sheets may be attached <br />(Exhibits B 6 E-MLR)- <br />r~ - ~ ~---~ -- <br />14. Please enclose Maps of Project Operation, Disturbance Areas and Reclamation (Exhibit <br />C.) This will expedite processing. Your cooperation is appreciated. <br />15, Prepared by! p.c~-i ~G~ ~~-~' Date: ~~Ui-i~/ 8 ~ ~8~ <br />-~ <br />n..- t _t n <br />