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hfINED LAND PEKh11'1' APPL1l:AN'1"S QU;;J'1'I0NNAIRE F'OR fY1LDLlr'l; <br />1. Name of Company:-~~ m. ~-!<_ ,j-Fp~ C~r~/~ <br />2. Name of Contact Person: N.,c,~ ~7.~1' ~~-r L~Qir~/j ~Y~4u7L <br />3. <br />4. <br />Phone Number: ~~.-~L/~ ~y~~l-. %,'Uc~ /~j~ <br />Alailing <br />5. Name of <br />6. Location <br />Address: ~/~,P1i/ Cry~U`~l~Q-/--- -- _--- <br />hf i n e : __~ ~ ~_ __~~ <br />of hfine: ,~%_f~/- ~4-r~~' %t~_ ~G'c~_.3l ~Llv ~~lN ~'4~. <br />Township, Range Section, ~nd Quarter Section <br />7. Land Ownership: (Circle) 1) Priva (2) BLht (3) Forest Service <br />er (Specify) _ _ _ <br />8. Present Land Use: ,~lii,ci r l~~ c~ ___ ____ <br />9. Proposed post-mining land use:~~~~~ <br />10. Type of Operation: (Circle) (1 Surface (2)-Underground <br />11. Number of surface acres disturbed oy mining operation (not includ- <br />ing roads): Z~ fi7Grt~ 5 <br />12. Miles of roads constructed, or to L~ constructed, associated with <br />mine operation (including exploratory roads): jz ~yJ;'~t <br />13. Approximate number of years mine will be in operation: %~,~~. <br />14 <br />Brief description of operation and reclamation plans (Additional <br />sheet may be attached); ,'tQ,3_m~~f// 6.~ /l~~nrr./~Lr ca -,ci <br />lF~d Lr.~ /'r .» [r,/ ~~ `~ 1. ~~ ~~~ri ,/o .,. .tip!/~~i, ~/.~ . c' d <br />/ / / <br />15. Please enclose a copy of a map showing the project disturbance areas, <br />and additional informatio^ on the operation, if the material is <br />available. This will help D01Y expedite processing a wildlife <br />statement for your h1LR application. Insufficient information on <br />project location and plans often result in a delay in providing a <br />statement. Your cooperation if appreciated/. <br />16. Prepared By :~~,~ ~Cp ~2 / Date : G~zL~Q~ <br />01-19-81 <br />cf <br />