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• ~ - -• f <br />III I_IIIIIIIIIIIIIII <br />MIA_.... ss~..".,,~,,,N <br />Application Worksheet/Checklist <br />Rea_ular 112 Application Operator •i <br />Mine Name i e No. ti- QO _Oq~ <br />Complete (i a to © p Q <br />Application Form• <br />ITEMS <br />Complete: I 1 <br />II 2 3 4 I 5 6 I 7 <br /> / '~ ~/ <br />ITEMS 8 9 10 11 12 13 <br />Complete: s ~ ~n,,ed A- p Pys <br /> rrn.., <br /> ~~ <br />~; <br />COMPLETENESS/ADEQUACY COMM"cNTS <br />Maos and Exhibits: , <br />EXHIBIT A -Legal Description <br />EXHIBIT B - lndex Idap <br />EXHIBIT C -Pre-Mining & Mining P1 an Map(s) <br />of Affected Lands <br />EXHIBIT D -Mining Plan, <br />EXHIBIT E -Reclamation Plan <br />