REV105593

• Permit No: C1984063
• IBM Index Class Name: Revision
• Doc Date: 7/6/1999
• Doc Name: application, application cover letter
• From: STEPHEN SELF
• To: DMG
• Type & Sequence: RN3
• Media Type: D
• Archive: No

APPLICATION REQUIREMENTS
Type or dearly print the appropriate origina{ or revised page numbers} of the permit application in the
spaces beknv. Where a map has been used to supplement or darify the narrative, indicate in the space
provided where the appropriate map(s) may be found in the application. The asterisk (`) denotes
sections where maps are required.
Each application for permit renewal must provide appropriate information .+hich minimally addresses
each of the following requirements. The narrative should describe the conditions which have been
encounterca during the previous permit term, and analyze how those conditions compare with those
antidpated in the original pem}t application. These narratives should be submitted as revised pages.
In cases where any item is not applicable, the applicant should so specify.
Location In A lication
INFORMATION CATEGORY NARRATIVE MAPS
2.03.4 Identification of Interests 8
2.03.5 Com liance Information 12
2.03.6 Ri hts of Ent and O eration Information 13
2.03.7 Relationship to Areas Designated Unsuitable 13
for Minin
2.03.8 Permit Term Information 14
2.03.9 Personal Injury and Property Damage 15
Information
2.08.5 Bondin Information 14 114A
2.03.10 Identification of Other Licenses and Permits 15-16
2.03.12 Newspaper Advertisement (Submit a copy of 17
the ro sed news a er advertisement
2.04.3 Site Description and Land Use Information 9 'Land Use
2.04(2)(a)
HGP-5,6,7
2.04.4 Cultural and Historic Resource Information 22
2.04.5 General Description of Hydrology and Geology 23-37 'Geology, surface
and ground water
systems of the
permit, adjacent
and general area
2.04.50

2.04.6 Geology Description 23-32 'Geology of the
permit area
2.04.6(1)(a) or
2.04.6(2)(a)
HGP-77 Fig 1-5 __