REV02132

• Permit No: M1979205
• IBM Index Class Name: Revision
• Doc Name: REGULAR 112 PERMIT APPLICATION FORM
• Type & Sequence: HR1
• Media Type: D
• Archive: No

- - -! -=tic (~ •',
•
;~ ";, iar.ds .erein cc nct affect env cf
..,: '•an~s :escr:'.ed it __cticn ilj('=)(f) Does not affect the described lands.
--e >1ir.ea Lana ~eclamatior, .,c*_.
wAPS v .:CH131T5
'diLi'e3ch a' tie five (j) COOTeS of t::G 3]aliC3ticr. for^.., t';e aC..-.IiC3nt ~11U5L SUb~it
a Co rtes aCn6ing 4LC a- t^e maps 2nd exiibi CS CuLlined in RU L. ?, a5 fallaw5:
(. cXl'131T A - Cegai descripticrt
Z. °_Xti13IT 3 - Index moo
3. _X~~131T C - Pre-minine S mining plan moo(s) -r affected lands
u. °-X:a131T D - `lining plan
j. c:(~I?IT - - Reclamation plan
~. _:(:i19I T ~ - Reclamation plan moo
i. -cXIf131T ; - 'water info rmaticn
:. ~X:i131T H -'di(dlife information
- SX~IBIT l - Soils info motion
l~J. cX~4131T J -Vegetation information
I1. 2X:~131T < - Climate
IZ. EXH131T L - Reclamation Casts
'~°: Ccncerninc the next three :X4131T5 ~y, N, 0: please rote t4at t:ie
_. July 1?i3 edition of the Rules and Reculatiorts cmics these :.:41?ITS.
_ finis was rtat a dal-ticn `:y t`~e )tined Land ieelamation Baarf; :`e
data recuired from tiesa ~:<ti131T5 was me.-ely cans..°err.d to a ew
52GtlOn in the Racu.l 3t;ons (,RL'L= 9, p. 46). Subse:vent issues c' the
Re ~U13CiCnS will ref'l ect tff e~CmiSaIOR of 7r. per =.-a$5-ref erena:nc in
_ tiffs regars. Please include, in •ieur perr,~it aOClic3ticn, =X4i51~:
!t, `1, C, as reGui red by RULE ".1 (1) , (2) and (j)
lj. °_XH13~T :t - local government approval ) Se_ RUL_ °.1(1)
I=. -cXHIBIT N - Cther pernics ar licenses ) Ses RUL= ~.1(Z)
I,. ~(h1I31T D - source of legal right eo enter ) Sae RUL= g.((3)'
15. ~CH13iT P - Owners ar record. or surface and sucsurjace rigits.
NOTICE ?ROC£JURES
.fret toe aoplicaticrt.is ccnsidered "filed" (pursuant to RUL"c l.l(i0) with :he
,tined Land Reciamatian Divisicn, notice procedures outlined in RUL_° Z.Z r,;est be
falle~ed. (=c mac for such notices ~.+ili be included in the letter you receive frcm
_-e >±LR ]tart inrC:~ing y0U of the C7mDIeCerte55 ("filing") of your apoficzGCrt.
ADDITIONAL I~IFORMATICN
finis spats can be referenced for further info nation of arty of the items in tiffs `era.
Tc tie best or ary ancwledge, all tie info mae'an ar-sen ni aeclicatien is
tr.~e and carrec_.
BY ~' Rohect W. Sack
TITLt Land and Resources
(Sicnature by indi,idual leeaily out:ori:_d ;o bind
tie operator to tiffs __clicaticn.)