PERMFILE65157

• Permit No: M1981002
• IBM Index Class Name: Permit File
• Doc Name: APPLICATION CHECKLIST
• Media Type: D
• Archive: No

7/]$ APPL I CAT 10'I Lii cCYL I ST ~ III III IIIIIIIIII III ~_a
sss
LIMITED IMPACT (110) ~ NAHE ~ c~- r FILE
SPECIAL 10-DAY (Ill) COMPLETE (FILED) DATE
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ITEM COMPLETE ADEQUATE COMMENTS
Aoolication Form:
1. Name of operation
L~
2. Name of applicant/operator J
3. Address r; phone, local J
4. Address E phone, general / I
5. Person to contact
6. Surface owners
7. Mineral owners L~
$. Source of legal right-to-enter
/~
9. Type of mine/substance ~_
10. General location b elevation
11. County
12. Acreage
13. Fee
(/
14. Present land use ~/
15• Proposed future use f
16. Signature
Maps and Exhibits
EXHIBIT A - Legal Description /
`' _
EXHIBIT 8 - Mining Plan `~
EXHIBIT C - Map v
EXH 161T D - Wildlife, Water Resources,
Vegetation, Soils Information / ~~„~,~
co~tiy,~d~..~