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<br />-3- <br />Note: If the application contains proposed (new) acreage, then a permit <br />revision application form must also be completed for those acreages. <br /> Permitted Actual Proposed <br />8. Mineral ownership: <br />(indicate currently <br />permitted acre for each) <br />Federal: ac., <br />State: - ac., <br />Private: ~ ac.,a.~• <br />Indian: ac. <br />9. Surface Ownership: <br />(indicate currently <br />permitted acreage for <br />each) <br />Federal: ac., <br />State: - ac., <br />Private: r ac.,aPFZOx• <br />Indian: ac. <br />10. Affected area (in acres) /js <br />11. Disturbed area (in acres) ~~~ <br />12. Acreage of area reclaimed <br /> <br />in previous permit term ~~S <br />a) backfilled and graded n/a n/a <br />b) retopsoiled n/a n/a <br />c) reseeded n/a n/a <br />13. Acreage for which band ,~,~yvG.QoA.D /'SAP <br />has been released <br />a) 60 percent n/a n/a <br />b) 85 percent n/a n/a <br />c) 100 percent n/a n/a <br />14. Renewal Term Requested <br />(Years) n/a n/a <br />15. Type of Mine (check one): Underground, Surface, <br />Combined Surface and underground, _ Load-0~; Other <br />16. Current Permit Status (check one Active, Temporary Cessation, <br />Permanent Cessation reclamation onl ~spended <br />17. Current Estimated Life of Mine in years: ~ ~yE,p,Q ~~c. <br /> <br />