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General Description (Miles and direction from nearest town and approximate elevation): <br />r%~~JQ ~EU~~' ~~d i1~+fY <br />Not for DP Ent <br /> Permitted Actual Pro osed <br />8. Mineral ownership: <br />Indicate current) ermitted acrea a for each <br />Federal: ~ acres <br />state: Dacres <br />Private: Z acres Z9 Z9 Z <br />Indian: G acres <br />9. Surface ownership: <br />Indicate current) ermitted acrea a for each <br />Federal: acres <br />State: acres <br />Private: ' acres ~ Z9 Zs <br />Indian: acres <br />10. Affected area in acres ~~3 ~Z /Z <br />11. Disturbed area in acres /Z jz. <br />12. Acreage of area reclaimed in previous permit <br />term <br />A. Backfilled and raded N/A cP N/A <br />B. Reto soiled N/A ~ N!A <br />C. Reseeded N/A / <br />l 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 / N/A <br />C. 100 ercent N/A ~ N/A <br />14. Renewal Term Re nested Years N/A N/A <br />Note: I/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): /~ Wnderground _ Surface <br />_ Combined Surface and Underground <br />Loadout Other <br />