Laserfiche WebLink
w/77 ,II IIIIIIIIIIIIIIII ~ MLVED fa.ND RECLa,~rATION • ~~'W' <br />Regular (112) Permit Application Checvl ist ~ ~p~ <br />File e7o. Name_~_~~~,Cu _ `~ ~~ `.p Date of Filing (Completeness) :` <br />ITEif COMPLETE ADEQUATE COMMENLS <br />Application %orm <br />1. Name of operation <br />2. name of applicant <br />3. Address & phone (local offices) / <br />4. Address & phone (gen'1. offices) i ~ <br />5. Person to contact <br />_ j <br />~ <br />6. Parent corporation (if any) <br />7. Surface owners <br />8. Piineral owners <br />9. Type of mine/substance / ~ <br />.0. General location & elevation ~ <br />.1. County <br />.2. Acreage / ~ <br />.3. Fee <br />i <br />.4. Present land use ~ ~ ~ ' <br />.5. Surrounding Land uses i <br />.6. Proposed future use / <br />.7. Other mining permits / <br />.8. Signature <br />.9. Prohibited Lands Statement <br />:faps ~ Exhibits <br />1. Legal description <br /> <br />i <br />2. Index map <br />3. Pre-mining & mining plan map <br />4. Mining plan - a) timetable <br />- b} depth 5 thickness of ore j <br />body <br />