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~ III IIIIIIIIIIIII III ~ <br />DIVISION OF MINERALS AND GEOLOGY <br />112 Construction Mining Operation <br />Application WorksheetlChecklist <br />New App: / Amendment App: Conversion App: <br />Operator: Hall-Irwin Construction COIRAany Mine ID: M-97-058 <br />Mine Name: Baseline Resource Submittal Date: 07/14/97 <br />APPLICATION FORM (Rule 1.4): <br />ITEMS <br />COMPLETED 1 2 3 4 5 6 <br /> / / / / / / <br />ITEMS <br />COMPLETED 7 8 9 10 11 12 <br /> / / / / / / <br />ITEMS 13 14 CONV/ADM PERMTEE SIG <br />COMPLETED DESCP RESP <br /> / / 1 2 3 / <br /> 4 5 6 <br /> 7 S 9 <br />MAPS and EXHIBITS (Rule 6.2 and 6.4) ADEQUACY COMMENTS <br />EXHIBIT A - 6.4.1 - LEGAL DESCRIPTION / <br />EXHIBIT B - 6.4.2 - INDEX MAP / <br />