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i ,,. <br />DIVISION OF MINERALS AND GEOLOGY <br />CONSTRUCTION MATERIALS <br />Regular (112) Mining Operation <br />Application Worksheet/Checklist <br />New App: _a~Aan Uda~ n~~ ~_ <br />Operator: ~lJGT~4~CVt'1 CarraJ,pall IQ,11 ry,_ <br />Mine Name : C',prv.r f~,i/tl Pik #3 '~ <br />APPLICATION FORM (Rule 1.6.2 and 1.6.3): <br />Conversion App: X <br />Mine ID: mA1~z~/ <br />Submittal Date: ~~~Z-IID~ <br />ITEMS <br />COMPLETED 1 2 3 4 5 6' <br /> / / ~/ / ~/ <br />ITEMS <br />COMPLETED 7 8 9 10 11 12 <br /> / / ,/ ~ / ~ <br />ITEMS <br />COMPLETED CONV/AMEND <br />DESCP PERMITEE <br />RESP SIG <br /> 1/2 /3/ <br />4/y6~ <br /> <br />(1GuJ fshP <br />~no}C,fuJ daiC9 <br />MAPS and EXHIBITS (Rule 6.2) <br />ADEQUACY COMMENTS <br />EXHIBIT A - 6.4.1 - LEGAL DESCRIPTION: <br />