Laserfiche WebLink
4/77 <br />D LAND RECLAPIATION III II~IIII~~~I~II~I <br />sss <br />Re~ulaS (3I2~__Permit Application Cherk3lst. <br />File ?I0. Z7- 39[ Name®~i,~. ~~tv{~ 4. T'~, ('~ , Date of Filing (Completeness) <br />t_ / a_ <br />ITE'i~f COMPLETE ADEOliATE COPII~it'NTS <br />Application Form <br />1. Name of operation <br />,,~~.//~~ <br />(~C Io/lr <br />2. Name of applicant ~t <br />3. Address E phone {local offices) u <br />4. Address ~ phone (gen'1. offices) t~ <br />5. Person to contact ' h <br />o. Parent corporation (if any) ~~ <br />7. Surface owners ~l <br /> <br />3. Piineral owners <br />i tl i <br />9. Type of minelsubstance ~l <br />C. General location 5 elevation ~ i, <br />1. County ~ p <br />2. Acreage a <br />3. Fee <br />• I <br />~ <br />4. Present land use ~ it <br />~. Surrounding land uses j ~~ <br />6. Proposed future use ~~ <br />7. Other mining permits p <br />S. Signature ~~ <br />.9. Prohibited Lands Statement v <br />*:aps & Exhibits <br /> <br />1. Legal description <br />i <br /> <br />2. Index map ~ <br />/ <br />! <br />I <br />3. Pre-mining & mining plan map ' <br />/ <br />4. Paining plan - a) timetable ! ~I~~ O <br />- b) depth b thickness of ore ~ i _ <br />1 <br />1 <br />1 <br />1 <br />1 <br />l <br />I <br />i <br />i <br />