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~ ~ <br />MINED LAND WILDLIFE QUESTIONAIRE <br />for limited impact and select regular mine applications <br />1. <br />2. <br />3. <br />4. Nearest Town/General Location: ~Gtf~! (A~DYaQ~ - ~ lMi~~ uh5f or Si"rE <br />S. Land Ownership (Circle) 1. Private 2. BLM 3, USFS 4. Other <br />6. Present Land Use: p ~Q,n~4 h4~1'~"GI/~ /'~-t -i/'~/~~L <br />7. Proposed Final Land Use: }~gT IQiNQ <br />8. Type of Operation: 1. Surface 2. Underground <br />9. Minerals being mined: ~ja.r,~ 9/aye-~ aap/2o~F <br />/T ~"~7 <br />10. Number and Description of Surface Acres Disturbed by Mining/not including roads <br />(Exhibit D-MLR) : !31 O Ac rPS '/ <br />11. Miles of roads to be constructed: rZ <br />12. Life of Mine (years): <br />13. <br />14 <br />15, <br />Description of Operation and Reclamation -- Additional sheets may be attached <br />(Exhibits B b E-MLR) _ _ ___. <br />~. ;_-._ <br />Location of Mine: 'sec 35 Er.~t 6i" UYKK ~,D w,+SB'.~(a. SwY4 I 11 N FCf>/ W <br />(County, Township, Range, Section to nearest quarter quarter; Exhibit A-P1LR appl.) <br />Please enclose Maps of Project Operation, Disturbance Areas and Reclamation (Exhibit <br />C.) This will expedite proc/essiyn~~g~.~Yopur cooperation is appreciated. Q <br />Prepared by: ~~y[j V. /G~/~ Date• ~,~i/(J~ <br />.. .r <br />