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C r' ~I 6. Owner(s) of record of affected Iand (surface area) (If morn than 2, list below) 8a.~. L. l/a,/iwn 7. Owner(s) of substance to be mined '/~v,(~. („ fJ1.Lx~n, ~wP~6 ~ntea, undea (If more than 2, list .below) 1 ~1//Ll.A(CLC. tI~rt v~ U. S. f~/7I1t~ CUR,~A U~ ~/LQ,lILEPJy 8. Source of Iegal right to enter (Indicate what type of proof is ~enAe _ ~xlub,~,f included in EXHIBIT G -lease, deed, notarized letter, etc.) 9. Type of mine s substance to be mined U~oe~e /~~ (Specify underground, open pit, quarry, etc. & substance(s) to .Sand d' yitave~ be mined) 10. General Location & elevation / mi.~e IJeA# v~ lavn,ia vn /Yo2(/t Fun{t yuivu.~vn (Miles S direction from nearest `/~cvert, /425 4Gb5 bane, Y~avn,ia, at appzvx,~mdfeC~ town 6 approximate situ elevation) 59~ ~ee# e,~evdf inrt 1I. County Jp~II 12. Acreage of affected lands (Total surface acreage to be 8.45 aatea.~ included in permit) 13. Application fee (See applicable RULE to determine amom~t) .3//5.A'I 19. Present land use (i.e.,, agri- S.fvRnse o~ vnch«td 2vfn}p~ eiiaipnen.t vrt Leae .fhan cultural, industrial, etc.) 2 acrt.e~, bolnrtce un~w.itnb.~e ;yit o.t/z.en. uaee. I5. Proposed future land use (Goal of reclamation) EXHIBIT A - Legal Description S.{~aaye U~ U/LCI1(U!d Relnfed e~ue/anen.f The legal description must identify the affected land and be wholly adequate for field location of the property. It can be in the form of metes 6 bounds survey or a descrip- tion by reference to township, range, and section, to at least the nearest quarter- quarter section. Where applicable, the street address or lot number(s) may be used. EXHIBIT B - Mining Plan This can be a general discussion of the methods, equipment, phases or stages of the operation and those areas of land affected by each. The plan should be correlated with the map and should show where extraction will begin, and which direction, if any, it will proceed.