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•+~v%~ ~ r <br /> <br />.~ ~^` r ~~ <br />• APPENDIX B. <br />MINED LAND WILDLIFE STATEMEM <br />For Limited Lnpact Operations <br />(Permit 110-1 and 110-2 ) or <br />Regular Operations (Permit 112) <br />Instructions to the Applicant: Submit this Wildlife Statement to MLRD as part of the <br />MLRD app icaEion. <br />Instructions to DOW District Wildlife Mana er: Review the attached Applicant's <br />Questiornaire, comp ete this orm, an sen of ack to the Regional Office. <br />Instructions to DOW Regional staff: Send completed copies of both the Applicant's <br />Questiomaire and Wildlife Statement along with pertinent correspondence to the <br />applicant, MLRD, and DWM. <br />The following information pertaining to wildlife is provided for use by the Mined Land <br />Reclamation Board in its consideration of a mining permit for: <br />1. Name and type Of mine: s w ~ ~N ~ ~~ ,E>,'f"C~/O. 3D ~wUerS~bH - ~ ro u P~ <br />2. Location of mine: ~ 7 /<.. i~ i. ~ o < ~' nT /~ / _ iG /~/1 <br />3. List threatened or endangered species (federal or state) and other species of <br />special concern present: <br />64 /d ,<"~a /~ <br />Flo. /z%u~. ~~uau,-,~'s~ <br />4. Assess expected impacts to fish and wildlife populations and habitat from project: <br />/VO S/S rii p'/C4.+t.~ //yl r~RG/~ L°.OC `J '~L/PL{~ 0/~t ccH~ Sr¢c~IGS, <br /> <br />