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-/; <br />LIHIT_7 IHFACT (I1C) _ <br />cpc,~;;,L 10-7.1Y (111) <br />1~=H <br />~"- <br />J.: <br />CCHFLc~c (rIL_U) JATc <br />COHPt=~~ an~~uar_ <br />FIL"c - <br />ccHrer,, <br />Aoo l i ca _ i cn For..+: <br /> <br />1. ?lame of oeeration ~ k <br />I <br />2. Yarre of applicant/operator ~ <br /> k <br />3. ,;dcress b phcne, local <br /> k <br />w. .address b phone, 5enerai ~ ~, <br />j. Person to contact ~ ~, I ! <br />! <br />6. Surrace owners ` ~ ~ ~ <br />7. Hinerai owners I <br /> <br />x I <br />I <br />3. :cures of lecai right-to-sneer I <br /> y <br />7. Hype or mine/substance I ! <br />{ <br />.0. 6erteral locacicn E elevation ~ ~ ~ <br /> <br />11. Ccunry I <br /> <br />1 ~, <br />1'?. ~crsace <br />~ X <br />c <br />1 <br />~ <br />I ~ ~ f <br />1+. Present land use I X <br />i5. Prceosed fature use I 1 <br /> X i <br />15. SignaCUro ~. <br />Haas and .x5 i b i is .. , <br />E;tHl31~ ,~ - LeSai Description ,+( <br />::::4i31T 9 - Hining Pian ( <br /> x <br />yRY1317 C - ~~ap ~ <br />X ~ ! <br />i <br />=:tri :51' 0 - ','i !ji i'e, 'mater Resour.es, <br />I I '' <br />Vecetaticr, Sc11; ir.`or-a-icn I ! nniSS~n1~ <br />