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<br /> <br /> <br />~ll II~II~II~II~~ II~ <br />DIVISION OF MINERALS AND GEOLOGY <br />Limited Impact 110 Construction Materials Operation <br />Application Worksheet/Checklist <br />New App: Amendment App: / Conversion App: <br />Operator: Lincoln County Mine ID: M-78-078 <br />Mine Name: Pickenpauoh Gravel Pit Submittal Date: 7/16/97 <br />APPLICATION FORM (Rule 1.4): <br />APPLICATION ITEMS COMPLETED <br />------ ~------- ------ ~ ------ ------ 3 ------ ------ 4 ------ ------ 5 ------ ------ 6 ------ ------~ ------ <br />/ / / / / / / <br />------ 8 ------ ------ 9 ------ ----- 1 ~ ----- ------1 ~------ ----- 1 ~ ----- ----- 13 ----- -----14------ <br />/ / / / / / / <br />____Initials____ __ S~nature __ ___ Notices ___ COMMENTS: <br />/ / / <br />EXHIBITS <br />------A------ ------B------ ------C------ ------~------ ------E------ ------F------ ------C'------- <br />/ / / / / / / <br />H I ,1 L Geotech Sign Affid. <br />/ / / OK / <br />COMPLETENESS COMMENTS: <br />