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~ ~ <br />MINED LAND RECLAMATION <br />Ap plication Worksheet/Checklist <br />III IIIIIIIIIIIII III <br />Limited Impact (110) Operator ~- „ ~ ,c ,yn ~, .,„, <br />Special 10-Day (l11) Mine Name ~ i e o. - - 52 <br />Carp/r~tntsr ,Q~v/1r. /fy,e~lmt; 5/J5/$g ~ e ate S/5/~S <br />Cw„pl~ir Sim/St e/%8' <br />Application Fonn: <br />ITEMS 1 2 3 4 5 6 7 <br />Complete: <br />~~25,UU SAY PR _ <br />ok ok ok ok ok c,F ok <br />ITEMS <br />Complete: 8 9 10 11 12 13 <br /> ok ak ok, ok ok ok <br />COMPLETENESS/ADEQUACY COMMENTS <br />Maps and Exh 1 bi is • dpp. ~ 9.9,x, - m, t su.c ~!~ hue/s, tie.. uArd d <br />l. fifir <)Osl. Leeks Irk,, ~.t nr~ rp,d' ~- <br />EXHIBIT A -Legal Descrlption ~K erczss no'/ ,'•cle,k/e~ o.v ulcerLlio~s. <br />EXHIBIT B -Site Description D-6" fps.%/' <br />a. Vegetation b Soils ok Nn cc~s.lti~RT ,~ scs .c sYeh' <br />b. Wi1d1 ife DEW raPnl rz ~rldle~ pzeaehy. <br />ok <br />c. Critical Structures <br />within 200 feet <br />off-site damage <br />EXHIBIT C -Mining Plan <br />N~nz txc:pf aaiss v+~A b 6, umsl>wc <br />ok <br />a~ mflvhq ? <br />EXHIBIT D -Reclamation Pt an S,Iwge mn, fb~~ 6" <br />a. P1 an MdY/MYm 9.aAer.'lofYtcla•.~s%,pts~ <br />ok <br />