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3 <br />• <br />• <br />(Not /or OP Entry1 <br /> Permitted Actual Proposed <br />8. Mineral ownership: <br />Indicate currently permitted acreage for each <br />Federal: O acres <br />State: O acres <br />Private: 38A acres 38, O 38,'C 35.0 <br />Indian: Q acres <br />9. Surface ownership: <br />Indicate currently permitted acreage for each <br />Federal: O acres <br />State: 0 acres <br />Private: ~$ 0 acres 38.0 38.2 38.21 <br />Indian: O acres <br />10. Affected area (in acres) ~Q, 7 $ I1. 12 No CNgIJf£ <br />11. Disturbed area (in ettes) 15.76 l l . IoZ !3c C8AN6E <br />12. Acreage of area reclaimed in previous permit <br />term <br />A. Backfilled and graded N/A 4,55 N/A <br />B. Retopsoiled N/A 4.55 N/A <br />C. Reseeded N1A 4. 55 N/A <br />13. Acreage for which bond has been released <br />A. 60 percent N/A q, 55 N/A <br />B. 85 percent N/A O N/A <br />C. 100 percent N/A O N/A <br />14. Renewal Term Requested (Years) N/A N/A <br />Note: /1 the application contains proposed Inew/ acreage, then a permit revision application <br />form must also be completed /or those acreages. <br />15. Type of Mine (Check one): _ Underground X Surface <br />Combined Surface and Underground <br />Loadout _ Other <br />• 16. Current Permit Status (Check one): _ Active _ Temporary Cessation <br />Permanent Cessation (Reclamation Only) _ Suspended <br />17. Current Estimated Life of Mine (in years): <br />