PERMFILE50621

• Permit No: C1980007
• IBM Index Class Name: Permit File
• Doc Date: 3/4/2002
• Doc Name: USFS Special Use Permit Application
• Section_Exhibit Name: Exhibit 80 Drilling Activities - MR270
• Media Type: D
• Archive: No

USDA -Forest Service FS-?700-3 (10/96)
OMB No. 0596-0052
•
C J
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I HEREBY CERTIFY, that I am of legal age and authorized to do business in the State and that I have personally
examined the information contained in the application and that this information is ccrrect to the best of my knowledge.
76a. Applicant' ig atur i n in ) t6b. Date
~ 5/31 00
Title 78. U.S.C. Section 700t, makes it a crime for any person knowingly and willfully to make to any department or
agency of fhe United States any false, fictitious, or fraudulent statements or representations as to any matter within its
jurisdiction.
• PART II-SUPPLEMENTAL INFORMATION (Applicant Completes)
MARK "X" IN APPROPRIATE
BOX BELOW
I-PRIVATE CORPORATIONS I ATTACHED FILED'
a. Articles of Incorporation [x) [ )
b. Corporation Bylaws be I [ i
A certification from the Stale showing [he corporation is in good standing and is entitled

a' to operate within the State. ~) [ I
d. Copy of resolution authorizing filing. pc I r )
e. The name and address of each shareholder owning 3 percent or mare of the shares,
together with the number and percentage of any class of voting shares of the entity
which such shareholder is authorized to vote and the name and address of each affiliate
of the entih/ together with, in the case of an affiliate controlled by the entity, the number
of shares and the percentage of any class of voting stock of that affiliate owned, directly
or indirectly, by that entity, and in the case of an affiliate which controls that entity, [he
number of shares and the percentage of any class of voting stock of that entity owned, ~ I [ I
direct) or indirect) , b the affiliate.
If application is for an oil or gas pipeline, describe any related right-of-way or temporary
f
use ermit a lications, and identi revious a olications ~) I [ I
If proposed land use involves other Federal lands identify each agency impacted by
g' ro osal. ~ I [ I
II -PUBLIC CORPORATIONS
a. Copy of law farming corporation [ I [ I
b. Proof of organization [ I [ )
c. Copy of Bylaws [ ) [ I
d. Copy of resolution authorizing filing ( ) [ I
If application is for an oil or gas pipeline, provide information required by Item "I-f" and

e' "I- "above. [ ) [ )
III--PARTNERSHIP OR OTHER UNINCORPORATED ENTITY
a. Articles of association, if any. [ [ [ I
b. If one partner is authorized to sign, resolution authorizing action is [ I [ i
c. Name antl address of each participant. partner, association or other [ [ I [ )
tl If application is for an od or gas pipeline, provide information requred by Item "I-f" and
I
[ I
[ I
"I- "above.
' If the regwred information is already filed with the Forest Service and is current, check box titled "Filed." Provide the
file identification information (e.g., number, date, code, name and office at which filed). If not on file or current, attach
requested information. private Corporation, the following information is attached
1) Certificate of Formation of Mountain Coal Company L.L.C., including
amendment 2) Restated Certificate of Incorporation 3) Bylaws 4) Minutes
of First Meeting of Board of Directors authorizing filing (cont. 4)
PaSp ] of 5