PERMFILE112477

• Permit No: M1977526
• IBM Index Class Name: Permit File
• Doc Date: 11/4/1977
• Doc Name: REGULAR 112 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

v
~~I2 Permit Application (Cond.)
RAPS d EXHIBITS
With each of the five (5) copies of the application form, the applicant must submit a
correepoadia~ set of the maps and exhibits outlined in Rule 2. as follows:
1. Exhibit A - Legal description
2. Exhibit B - Indea map
3. Ezhibit C - Pre-miaiag 6 r:'-~.~g plea map(s) of affected lands
4. Exhibit D - ''+ning plan
5. Exhibit E - xeelamatioa plan
6. Ezhibit F - Reclamation plan map
7. Exhibit G - Water information
8. Exhibit H - Wildlife information
9. Exhi' I - S: i? a information
.C. E~chibit J - Vegetation information
:~_1. Exhibit K - Climate
~~. Exhib:'.t L - 3eclamation Coats
5.~. Exhibit M - Local government approval
:~:.~ Exh;l:oit N - Othnr permits or 'licensee
i.5. Exhibit 0 - $OL...:~ of legal right to Pcnter
L6. Exhibit P - Owners of record of surface
s subsurface rights.
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NCTICE PIIOCEL"J3E5
.lfter the application las been filed vith *_he Division, notice procedures ou*_liaed in
=.tc1e 2.2 must be followed.
ADDITIO.\AL INF"O~fATION
This apace can be refereUc.ed for fu-tser information of any of the items on this form.

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To the hest of n'y knowledge, all the i:.formatior. presented in this application is true sad
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(Signature by individual legally authorized
` to bind the operator to this application.)