PERMFILE106075

• Permit No: M1986104
• IBM Index Class Name: Permit File
• Doc Name: APPLICATION FOR A MINED LAND RECLAMATION PERMIT
• Media Type: D
• Archive: No

-4-
ADDITIONAL INFORMATION
This space can be referenced for fur[her information of any of the items in this form.
To the best of my knowledge, all the information presented in this application is [rue
and correct.
Date:
By: X
//~~~
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Title
(Signature by individual legally authorized to
bind the operator to this application)
(Rev. 4/84)
Doc. No. 5547