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3 <br />General Description (Miles and direction from nearest town and approximate elevation): <br />Not for DP Ent <br /> Permitted Actual Pro osed <br />8. Mineral ownership: <br />Indicate current) rmitted acrea a for each <br />Federal: r~ acres <br />State: Dacres <br />Private: ~ acres 29 Z Z <br />Indian: d acres <br />9. Surface ownership: <br />Indicate current) nnitted acrea a for each <br />Federal: acres <br />State: acres <br />Private: acres ~ li`7 Z <br />Indian: acres <br />10. Affected area in acres ~~~ ~z IZ <br />11. Disturbed area in acres IZ !Z <br />12. Acreage of area reclaimed in previous permit <br />term <br />A. Backfilled and raded N/A ~ N/A <br />B. Reto soiled N/A L N/A <br />C. Reseeded N/A ~ N/A <br />13. Acrea a for which bond has been released <br />A. 60 ercent N/A N/A <br />B. 85 ercent N/A / <br />cp N/A <br />C. 100 ercent N/A ~ N/A <br />14. Renewal Tenn Re nested Years N/A N/A <br />Note: If the application contains proposed (new) acreage, then a permit revision application <br />form must also be completed for those acreages. <br />15. Type of Mine (Check one): / ~llnderground _ Surface <br />_ Combined Surtace and Underground <br />Loadout Other <br />