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• .REVISED MAY 22, 1992 <br />_3_ <br />8. <br />9. <br />10. <br />11. <br />12. <br />a) <br />b) <br />C) <br />13. <br />a) <br />b) <br />C) <br />14. <br />n/a <br />n/a <br />n/a <br />n/a <br />n/a <br />n/a <br />5 <br />Note: If the application contains proposed (new) acreage, then a permit <br />revision application form must also be completed for those acrea <br />15. Type of Mine (check one): Underground, x Surface, <br />Combined Surface and underground, x Load-0u~' Other- <br />16. Current Permit Status (checfc one): x Active, Temporary Cessation, <br />Permanent Cessation (reclamation only), ~ispended <br />17. Current Estimated Life of Mine 1n years: 2 5 <br />Mineral ownership: <br />(indicate currently <br />permitted acre for each) <br />Federal: ac., <br />State: aC., <br />Private: - ac. , <br />Indian: - ac. <br />Surtace Ownership: <br />(indicate currently <br />permitted acreage for <br />each ) <br />Federal: _ ac., <br />State: dC., <br />Private: - ac., <br />Indian: - ac. <br />Affected area (in acres) <br />Disturbed area (in acres) <br />Acreage of area reclaimed <br />in previous permit term <br />backfilled and graded <br />retopsoiled <br />reseeded <br />Acreage for which band <br />has been released <br />60 percent <br />85 percent <br />100 percent <br />Renewai Term Requested <br />(Years ) <br />tted <br />2924.35 <br />0 <br />0 <br />0 <br />188.99 <br />~~ <br />533.65 <br />0 <br />2646 <br />2646 <br />n/a <br />n/a <br />n/a <br />n/a <br />n/a <br />n/a <br />n/a <br />Actual <br />2924.35 <br />0 <br />0 <br />0 <br />3420.99 <br />640 <br />0 <br />0 <br />188.99 <br />0 <br />5335.65 <br />0 <br />1887 <br />1887 <br />176 <br />176 <br />176 <br />226 <br />176 <br />n/a <br />508.99 <br />640. <br />6293.50 <br />0 <br />3810 <br />3810 <br />