PERMFILE107775

• Permit No: C1984063
• IBM Index Class Name: Permit File
• Doc Date: 12/7/2004
• Section_Exhibit Name: Application Form
• Media Type: D
• Archive: No

16. Current Permit Status (Check one): _ Active
Permanent Cessation (Reclamation Only)
_ Suspended
17. Current Estimated Life of Mine (in years): f~,~
Temporary Cessation
_ InactivelPhase II Bond Release
APPLICATION REQUIREMENTS
Type or clearly print the appropriate original or revised page number(s) of the permit application in the
spaces below. Where a map has been used to supplement or clarify 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 which minimally addresses
each of the following requirements. The narrative should describe the conditions which have been
encountered during the previous permit term, and analyze how those conditions compare with those
anticipated in the original permit 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
2.03.5 Com liance Information
2.03.6 Ri hts of Ent and O eration Information ~c3
2.03.7 Relationship to Areas Designated Unsuitable /3
for Minin
2.03.8 Permit Term Information / ¢-
2.03.9 Personal Injury and Property Damage ~s
Information
2.08.5 Bondin Information / ¢ .~
2.03.101dentification of Other Licenses and Permits ~ /
2.03.12NewspaperRdvertisement (Submit a copy of 7 '7
the ro osed news a eradvertisement
e ~i~
~
U
2.04.3 Site Description and Land Use Information c3
/ an
s
2.04 2 a
2.04.4 Cultural and Historic Resource Information ZZ
2.04.5 General Description of Hydrology and Geology Z3 37 'Geology, surface
and ground water
systems of the
permit, adjacent
and general area
2.04.5(1)
/dlrP- /7 ,r
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