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--~ <br />111111111111 „~~ <br />DIVISION OF MINERALS AND GEOLOGY <br />112 Regular Operation <br />Application Worksheet/Checklist <br />Nev ADD: ~ ~p II Amendment Apo: C//o~~nversion Ano: <br />Operator: ~r~l-Ol 0_V~i-t~ Mine ID: ~'( ~'7 - ~ n~~ <br />Mine Name:,ynq per-('S~IfSY~F'Y~t h"!-~f, ~" Submittal Date: ~ ~a `-t ~. <br />APPLICATION FORM: <br />ITEMS <br />COMPLETED 1 2 3 4 5 6 7 <br /> ~ ~.m <br />ITEMS 8 9 10 11 12 13 14 <br />COMPLETED <br />MAPS and EXHIBITS / ADEQUACY COMMENTS <br />EXHIBIT A - LEGAL DESCRIPTION"/ <br />EXHIBIT B - INDEX MAP ~/ <br />EXHIBIT C - PRE-MINING AND MINING PLAN MAP(S) OF AFFECTED LANDS <br />EXHIBIT D - MINING PLAN <br />