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~~ ~ ~ ~~ • ~ <br /> MI+ LAND WILDLIFE QUESTIONNAIRE • <br />i For Limited Impact and Select Regular Mine Applications <br />1. Name of Company/Mine: ~C,0.1V~~~TTE Yf9 11L1G,~. • <br />2. N <br />a <br />me/ <br />Address/Phone of Contact Person: ~ f~ ~y ,~ rj <br />7~ <br />r1 1y3Ti•iiLLs <br /> _ <br />n <br /> / <br />~ <br />~ <br />3. Location of Mine: SL/ l~~ ~/!~~/l~ ~~+C 30 ~ ZZ.S ~7LL~J G~~ <br /> (County, Township, Range, S tion to nearest quarter qu ter; Exhi t A-MLR appl.) <br />4. Nearest Town/General Location: /J/L3S~'-L° L/ ~ ~CIO/2,~-/, d <br />5. Land Ownership (Circle) 1: rivate 2. BLM 3. USFS 4. Other <br />6. PresenC Land Use: ~~-t~T'J~~~ ' <br />7. Proposed Final Land Use: (./ / L ~ L i~'E ~~-8/ T.4-% <br /> <br />8. Type of Operation: 1 Surface ,. 2. Underground . <br />9. Minerals being mined: ~Q X.} V~-L. <br />10. Number and Description <br />of Surface Acres Disturbed by Mining/not inclu ding roads <br /> // <br />(Exhibit I}-DII.R): y, <br />11. Miles of roads to be constructed: _ ~1 ~ _ __ __ <br />12. Life of dine (years): `,7 - <br />13. Description of Operation and Reclamation -- Additional sheets may be attached <br />(Exhibits ff b E-MLR) . <br />14. 'Please enclose Maps of Project Operation, Disturbance Areas and Reclamation (Exhibit <br />C.) This will ~exp)e~di~ttek'proc~e"ss~ing. Your cooperation is appreciated. / p <br />15, Prepared by:_ G(/G6~Ki~C. (iy ~~~' Date: ~CB ~ rP. ~78J~ . <br />Par. P, 1 of 2 <br />L <br />