REV100619

• Permit No: M2003092
• IBM Index Class Name: Revision
• Doc Date: 10/12/2005
• Doc Name: Reclamation Permit Application Form
• From: Nick H. Gray
• To: DMG
• Media Type: D
• Archive: No

EXHIBIT S -Permanent Man -Made Structures
The applicant owns all land within 200 feet of the boundary of the proposed area of
operations. The following man-made structure is within two (200) hundred feet of the
proposed azea to be affected. The location may be found on the Exhibit C -Map.
• Irrigation Pond, ditches and fences owned by Nick Gray. A damage waiver is attached.